Fibromyalgia Index Predicts More Suffering - Even if you Don't Have FM

Cort

Founder of Health Rising and Phoenix Rising
Staff member
Pain-collage.jpg
Talk about a "spectrum disorder". These researchers took arthritis patients - removed all the FM patients from them - and then examined their fibromyalgia score. They found that having a high fibromyalgia score - even if they didn't meet the criteria for FM - was an amazingly powerful predictor of how much suffering the arthritis patients would experience.

A higher fibromyalgia score, a validated self-report measure of pain and comorbid symptoms, independently predicted less improvement in pain (P<0.00001), Chad M. Brummett MD, assistant professor, University of Michigan Health System, Department of Anesthesiology, Division of Pain Medicine, Ann Arbor, and colleagues reported in Arthritis and Rheumatology.
In fact the index was the only measure that predicted poorer outcomes across all the symptom domains.

"it" was the only preoperative phenotypic measure to consistently show predictive utility across the different outcome domains,"
They believe that alterations in pain and sensory processing are causing the problems in patients with higher FM scores (but not FM). They needed more opioids after the surgery, experienced more mood disorders, was less able to function physically and catastrophized more.

The study found that higher fibromyalgia scores were associated with higher preoperative pain severity and use of neuropathic pain descriptors, more negative affect (i.e., depression and anxiety), increased tendency to catastrophize their pain, worse physical function, and more opioid use.
Given that there is probably a subset of patients in every pain disorder who experience higher FM symptoms and are likely to get worse and worse, this finding is a big deal.

"Additional research is needed to identify the precise biological underpinning of the poorer outcomes associated with higher fibromyalgia survey scores as well as whether this measure might finally allow us to move toward the elusive "personalized analgesic" sought for acute and chronic pain."
This study indicates that whatever is causing FM is producing huge amounts of distress not just in FM in many disorders that involve pain - and has huge economic implications.

FM gets lower per patient funding than does ME/CFS. This study suggests that if the NIH is serious about reducing the pain epidemic present in the US, they should start funneling truckloads of funding into FM. It's where the answers will be found.
 
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Grace2U

Active Member
Regarding:
http://www.medpagetoday.com/Rheumatology/Fibromyalgia/50699

Initially, I looked at this report negatively, regarding its relevance, but perhaps it's a warning to those of us experiencing knee or hip pain to be weary of any surgical intervention. And I quote from their report:

"Despite starting with higher baseline pain, "patients with higher fibromyalgia survey scores were still less likely to meet the threshold for change in overall pain and change in affected knee or hip pain" noted the authors."

I am bothered though by this statement from the report:

"The study found that higher fibromyalgia scores were associated with higher preoperative pain severity and use of neuropathic pain descriptors, more negative affect (i.e., depression and anxiety), increased tendency to catastrophize their pain, worse physical function, and more opioid use."

How can they cluster the six outcomes? Were each six measured independent of one another? And how does one determine if someone is "catastrophizing" their pain?

Thank you for posting Cort :)
 

Seeksassy

Active Member
I'm not exactly on point here, but there's a concept in here that I keep seeing related to FM that confuses me because it always feels, to me, that it's saying we exaggerate our symptoms, or that catastrophizing is somehow a psychological symptom, or not valid somehow. : catastrophizing....how exactly is this defined in relation to FM? I feel like having FM has been catastrophic to my life. Here's the first entry I found for definition: 1. a sudden and widespread disaster
2. any misfortune, mishap, or failure; fiasco
3. a final event or conclusion, usually an unfortunate one; a disastrous end.
All of these definitely define my experience with FM, and CFS, and CRPS. So, am I being too sensitive in feeling this term is often used in a pejorative sense? Or a psychological one? Why is the term often used as a "symptom" for how some of us describe our situations? OF COURSE IT'S A CATASTROPY!!!!
 

Grace2U

Active Member
I'm not exactly on point here, but there's a concept in here that I keep seeing related to FM that confuses me because it always feels, to me, that it's saying we exaggerate our symptoms, or that catastrophizing is somehow a psychological symptom, or not valid somehow. : catastrophizing....how exactly is this defined in relation to FM? I feel like having FM has been catastrophic to my life. Here's the first entry I found for definition: 1. a sudden and widespread disaster
2. any misfortune, mishap, or failure; fiasco
3. a final event or conclusion, usually an unfortunate one; a disastrous end.
All of these definitely define my experience with FM, and CFS, and CRPS. So, am I being too sensitive in feeling this term is often used in a pejorative sense? Or a psychological one? Why is the term often used as a "symptom" for how some of us describe our situations? OF COURSE IT'S A CATASTROPY!!!!
I remember coming across this term when I attended a 3 week pain program in 2011. It was suggested by the "experts" that catastrophizing meant to take one's pain to a higher level by dwelling on it or allowing it to consume a level of one's thinking that is greater than the level of actual pain. What??? Don't get me wrong, I realize the benefit of using distraction and positive thinking..... but this was very different.

It was frowned upon by the "experts" to rub the area that was experiencing pain (arm or low back for example) or give in to the pain by allowing one's facial expression to convey pain. I felt, in hind sight, I was paying big bucks for the "experts" to apply, yet another, theory as to how to reduce pain levels. Perhaps it is me, but I found no benefit from their approach. Thanks for the input SeekSassy :) :) :) :) :) No frowning for me! LOL
 

Cort

Founder of Health Rising and Phoenix Rising
Staff member
I'm not exactly on point here, but there's a concept in here that I keep seeing related to FM that confuses me because it always feels, to me, that it's saying we exaggerate our symptoms, or that catastrophizing is somehow a psychological symptom, or not valid somehow. : catastrophizing....how exactly is this defined in relation to FM? I feel like having FM has been catastrophic to my life. Here's the first entry I found for definition: 1. a sudden and widespread disaster
2. any misfortune, mishap, or failure; fiasco
3. a final event or conclusion, usually an unfortunate one; a disastrous end.
All of these definitely define my experience with FM, and CFS, and CRPS. So, am I being too sensitive in feeling this term is often used in a pejorative sense? Or a psychological one? Why is the term often used as a "symptom" for how some of us describe our situations? OF COURSE IT'S A CATASTROPY!!!!
Of course it is :)...
This is a telling point. Because being in pain is by definition pretty much of a catastrophe - castrophizing - worrying, ruminating, etc. about it - is a natural response to it. It's our bodies response to injury! Why don't they bring THAT out? Probably because they themselves don't have any experience with it...

It is still true that "catastrophizing' probably because it further imbalances the autonomic nervous system by loading more stress on it - IMO - increases pain....That's my kind of personal experience.
 

Seeksassy

Active Member
I guess I do understand what is meant by the term but I don't like it. That said, people with chronic pain (or other chronic health issues) get used to it over time. Or at least eventually come to a place of tolerance, if not acceptance, of their new reality. I guess I should be using the first person here, but this aspect of chronic health experiences applies to everyone I know with the problem. In the beginning of conditions with unknown etiology it can be unbelievable that there is no identifiable physical cause for such exquisite pain. That was certainly true for me and I pushed my doc for all kinds of tests even tho she diagnosed me with FM right off. So, is this initial disbelief interpreted as castrophizing (well, maybe not just initially, it took me about 3 years believe FM was real and not going away)? Because I think it's a normal reaction.
 

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