Usefulness of tenderness to characterise fibromyalgia severity in women

OBJECTIVES: To investigate the usefulness of tenderness (tender points count (TPC) and algometer score) to characterise fibromyalgia (FM) severity and symptomatology in women.

METHODS: The study sample comprised 174 women aged 51±7 years. We ossesse tenderness using pressure algometry; quality of life by means of the Short-Form 36 Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS). We used the FM impact questionnaire (FIQ) to assess FM severity and symptomatology. Patients were categorised according to three FIQ-derived categories: FIQ<70 vs. ≥70; FIQ<59 vs. ≥59; and FM-type I and II.

RESULTS: TPC was significantly higher in the group of patients with FIQ≥59 (16.9±2 vs. 15.6±4, p=0.02), whereas no differences between groups were observed according to FIQ≥70 (17.0±2 vs. 16.2±3, p=0.12) or FM type (16.8±3 for type II vs. 15.9±4 for type I, p=0.13). We observed a significant association between TPC and FIQ-job difficulty, pain, morning tiredness and stiffness dimensions (all p<0.05), yet it was not correlated with total score of FIQ, FIQ-anxiety, fatigue and depression dimensions (all p>0.05). Algometer score was lower in the FIQ≥70 (45.7±12 vs. 51.1±14, p=0.05) and FIQ≥59 (46.7±13 vs. 52.7±14, p=0.05) groups, and there were no difference between FM types (48.7±13 vs. 49.5±14 for type II and I respectively, p=0.81). Algometer score was not associated with total score of FIQ or FIQ dimensions (all p≥0.1).

CONCLUSIONS: Widespread pain and pain hypersensitivity, as measured by TPC and algometer score, do not seem to be useful to characterise FM severity and symptomatology (measured by FIQ) in women.