Gender Differences in Pain Severity, Disability, Depression, and Widespread Pressure Pain Sensitivity in Patients with Fibromyalgia Syndrome Without Comorbid Conditions

Authors

  • Adelaida M. Castro-Sánchez PT, PhD,

    1. Department of Nursing and Physical Therapy, Universidad de Almeria, Almeria, Spain
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  • Guillermo A. Matarán-Peñarrocha MD,

    1. Health District Granada, Andalusia Health Service, Granada, Spain
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  • María M. López-Rodríguez PT,

    1. Department of Nursing and Physical Therapy, Universidad de Almeria, Almeria, Spain
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  • Inmaculada C. Lara-Palomo PT,

    1. Department of Nursing and Physical Therapy, Universidad de Almeria, Almeria, Spain
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  • Lars Arendt-Nielsen PhD,

    1. Centre for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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  • César Fernández-de-las-Peñas PT, MSc, PhD

    Corresponding author
    1. Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
    2. Esthesiology Laboratory, Universidad Rey Juan Carlos, Alcorcón, Spain
    • Centre for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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  • Conflict of interest: No conflict of interest has been declared by the author(s).
  • Funds: No funds were received for this study.

Reprint requests to: César Fernández-de-las-Peñas, PT, MSc, PhD, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain. Tel: + 34 91 488 88 84; Fax: + 34 91 488 89 57; E-mail: cesar.fernandez@urjc.es.

Abstract

Objectives

To determine the differences in pain, disability, depression, and pressure sensitivity between men and women with fibromyalgia syndrome (FMS), and to analyze the relationship between pain and pressure sensitivity in FMS.

Design

A cross-sectional study.

Setting

Gender differences in pain sensitivity in individuals with FMS have not been yet clarified.

Patients

Twenty-four men (age: 52 ± 6 years) and 24 age-matched women (age: 52 ± 5 years) with FMS diagnosed according to 1990 American College of Rheumatology criteria participated.

Outcome Measures

Pressure pain thresholds (PPTs) over the 18 tender points and over the second metacarpal and tibialis anterior muscle were assessed. The intensity and duration of pain, tender point count, the Fibromyalgia Impact Questionnaire, and depression (Beck Depression Inventory-II) were calculated.

Results

Women reported higher intensity of pain, tender point count, and depression than men (P < 0.01). Men reported a longer history of pain and disability than women (P = 0.005). Women showed bilateral lower PPT over suboccipital, cervical spine, second rib, supraspinatus, lateral epicondyle, gluteal region, and second metacarpal than men (P < 0.05). Negative associations between tender point count and PPT were found in men and women. In men, negative correlations between the intensity of ongoing pain and PPT over the cervical spine were found. No significant association between PPT and other clinical outcome was seen.

Conclusions

Women with FMS showed higher pain severity and lower PPT than men, whereas men exhibited longer duration of symptoms and disability. In men with FMS, the intensity of ongoing pain was positively correlated to pressure hyperalgesia over the neck. This study suggests that FMS could show a different phenotype in women and men and confirm that women exhibit lower PPT than men.

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