Myalgia in 30 Patients with Suspected Myopathy.

Diana Lehmann Urban,Elizabeth Lehmann,Torsten Kraya,Leila Motlagh Scholle

doi:10.3390/ijerph17072502

Abstract

Background: In patients with neuromuscular disorder, only little data of myalgia frequency and characterization exists. To date, only a weak correlation between pain intensity and pressure pain threshold has been found, and it remains enigmatic whether high pain intensity levels are equivalent to high pain sensitivity levels in neuromuscular disorders. Methods: 30 sequential patients with suspected neuromuscular disorder and myalgia were analyzed with regard to myalgia characteristics and clinical findings, including symptoms of depression and anxiety and pain- threshold. Results: A neuromuscular disorder was diagnosed in 14/30 patients. Muscular pain fasciculation syndrome (MPFS) without evidence for myopathy or myositis was diagnosed in 10/30 patients and 6/30 patients were diagnosed with pure myalgia without evidence for a neuromuscular disorder (e.g., myopathy, myositis, MPFS, polymyalgia rheumatica). Highest median pain scores were found in patients with pure myalgia and polymyalgia rheumatica. Pressure pain threshold measurement showed a significant difference between patients and controls in the biceps brachii muscle. Conclusion: Only a weak correlation between pain intensity and pressure pain threshold has been suggested, which is concordant with our results. The hypothesis that high pain intensity levels are equivalent to high pain sensitivity levels was not demonstrated.

Highlights

The International Organization for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of an injury
It is already known that myalgia occurs in different muscle disorders, e.g., proximal myotonic myopathy (PROMM) [3], occulopharyngeal muscular dystrophy (OPMD) [4], myositis [5], statin-induced myopathy [6], and mitochondrial myopathy [7]
(n = 1), myoadenylate deaminase deficiency (MADD) (n = 1), anoctamin5- myopathy (n = 1) and mitochondrial myopathy without a genetic cause (n = 1); (II) six patients with myopthy; (III) two patients with polymyositis and (IV) two patients with polymyalgia rheumatica (PMR). In this group of patients with neuromuscular disorders (n = 14), EMG showed myopathic changes in 5/14 patients, elevated CK was observed in 4/14 patients and myopathic changes in muscle biopsy was found in 12/14 patients

Summary

Introduction

The International Organization for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of an injury. Different data regarding the characterization of myalgia in patients with defined muscle diseases exist. The aim of this study was the clinical characterization and measurement of myalgia in patients with suspected neuromuscular disorder and the association to depression and anxiety symptoms. Only a weak correlation between pain intensity and pressure pain threshold has been found, and it remains enigmatic as to whether. Only a weak correlation between pain intensity and pressure pain threshold has been found, and it remains enigmatic whether high pain intensity levels are equivalent to high pain sensitivity levels in neuromuscular disorders. Methods: 30 sequential patients with suspected neuromuscular disorder and myalgia were analyzed with regard to myalgia characteristics and clinical findings, including symptoms of depression and anxiety and pain- threshold. The hypothesis that high pain intensity levels are equivalent to high pain sensitivity levels was not demonstrated

Objectives

Results

Discussion

Conclusion