Pain Characteristics of Patients With Fibromyalgia: A Comparison Between Gender and Different Emotional States

Abstract

BACKGROUND: Generalized pain is the core symptom of fibromyalgia (FM). Few studies have described FM’s different pain characteristics under various conditions. OBJECTIVE: To explore the pain characteristics of patients with FM of different gender and emotional states. STUDY DESIGN: A cross-sectional study. SETTING: A medical center in Beijing, People’s Republic of China. METHODS: A total of 197 patients with FM were recruited from an outpatient clinic. Three distinct instruments were used to assess their pain characteristics: the Numeric Rating Scale (NRS-11) to assess pain severity, the Widespread Pain Index (WPI) to assess the number of pain regions, and the Short Form-McGill Pain Questionnaire-2 (SF-MPQ-2) to assess pain qualities. The Zung Self-Rating Anxiety Scale and Zung Self-Rating Depression Scale were used to assess patients’ emotional states. An independent 2-sample t test, chi-squared test, and Mann-Whitney U test were used to analyze gender pain characteristics differences and different emotional states (with/without anxiety, with/without depression). RESULTS: Pain severity on the NRS-11 was 7 (5–8), the number of pain regions determined by WPI was 13 (10–16), and the total score of different pain qualities from the SF-MPQ-2 was 2.36 (1.68–3.73) in all patients with FM. The most frequently reported regions of pain were the right shoulder girdle (89.34%), left shoulder girdle (88.32%), upper back (85.28%), and neck (81.73%). The most frequently reported pain qualities were tiredness/exhaustion (97.46%), aching pain (94.42%), numbness (78.68%), cold/freezing pain (75.63%), and tenderness (75.13%). Women patients reported more severe pain and numbness, less frequent chest pain, and shooting pain than men patients did. Patients with FM and anxiety experienced more frequent and more severe feelings of punishing/cruel thoughts, fearfulness, sickening, and tenderness; more frequent jaw pain and cold-freezing pain; more severe pain caused by light touch and tiredness/exhaustion; less frequent lower leg pain than those without anxiety did. Patients with FM and depression reported more frequent and more severe pain caused by light touch; more frequent tenderness; more severe feelings of tiredness/exhaustion, sickening,fearfulness, and punishing/cruel thoughts; and less frequent and less severe piercing pain than those without depression did. LIMITATIONS: The limitations of this study are its single-center design and lack of objective pain indicators. CONCLUSION: Gender significantly affected pain severity, chest pain, numbness, and shooting pain. Jaw pain, lower leg pain, cold/freezing pain, tenderness, pain caused by light touch, piercing pain, and pain-affective descriptors are closely related to emotional states in FM. A comprehensive understanding of pain characteristics in patients with FM would be helpful for disease education, diagnosis, and treatment. KEY WORDS: Fibromyalgia, men, women, anxiety, depression, pain severity, pain regions, pain quality