Abstract

Background Chronic widespread pain and sleep disturbance are among the most common symptoms reported by patients with fibromyalgia (FM). Objectives This study assessed the level of pain and sleep disturbance in FM patients using a daily pain and sleep quality diary, the Short-Form McGill Pain Questionnaire (SF-MPQ), and the Manual Tender Point Survey (MTPS). Methods Patients recorded their levels of pain severity and sleep quality for approximately 7 days using an 11-point numerical rating scale (ranging from 0 = no pain/best possible sleep to 10 = worst possible pain/sleep, respectively). The SF-MPQ measured pain quality and severity (range 0–3) with 11 sensory and 4 affective descriptors, and pain severity using a 100 mm visual analogue scale (VAS). The MTPS assessed the presence of pain at each of 18 tender points corresponding to those specified by the American College of Rheumatology (ACR) 1990, and 3 control points. Patients rated the severity of pain upon palpation of each of the tender and control points on a 0–10 point scale (Tender Point Pain Intensity Score). These measures were administered to 529 patients diagnosed with FM using the ACR criteria during the baseline period of a clinical drug trial. The mean age was 48.6 years, 91.5% were female, and the mean duration of FM was 107.7 months. Results Patients with FM reported a mean pain score of 7.0(+1.3) and mean sleep quality score of 6.5(+1.7) on the 0–10 point scale. Over 95% of patients selected the descriptors aching, tender and tiring-exhausting. The mean pain score as measured by the VAS of the SF-MPQ was 74.8(+14.2) on the 0–100 point scale. The mean number of tender points was 17.1(+1.5) of 18 possible; the mean Tender Point Pain Intensity Score (0–10 point scale) was 6.1(+1.8), while control point mean pain severity was 2.0(+1.9). Conclusion Patients with FM reported a moderate to severe level of pain and sleep disturbance. Pain severity was consistently reported across the three measures of pain, the daily pain diary, the VAS, and the Tender Point Pain Intensity Score. Nearly all patients consistently described their pain as tender, aching and tiring-exhausting. Additional studies need to be completed to characterise further the pain and sleep disturbance prevalent in patients with FM, and to assess and define other symptoms involved in the FM syndrome (see companion abstract by Sesti, et al.).

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