Pressure Pain Threshold and Anxiety in Adolescent Females With and Without Juvenile Fibromyalgia: A Pilot Study

Overview

Journal Clin J Pain

Specialties Neurology
Psychiatry

Date 2016 Nov 15

PMID 27841836

Citations 16

Authors

Christopher D King

Kristen E Jastrowski Mano

Kimberly A Barnett

Megan Pfeiffer

Tracy V Ting

Susmita Kashikar-Zuck

Affiliations

Soon will be listed here.

Abstract

Objectives: Reduced pain thresholds have been documented in adult fibromyalgia, but there are no quantitative studies of altered pain sensitivity in adolescents with juvenile fibromyalgia (JFM). The current study examined differences in pressure pain sensitivity between adolescent females with JFM and healthy controls. The relationship between levels of anxiety and pain were also examined.

Methods: A total of 34 JFM (15.4±1.4 y old) and 31 controls (14.5±1.3 y old) completed self-report measures of pain and anxiety. Pressure pain threshold was assessed (palm and forehead sites) with a hand-held algometer. Participants indicated the first sensation of pain and then rated the intensity of pain on a Numerical Rating Scale.

Results: Adolescents with JFM exhibited greater sensitivity to pressure pain compared with controls. While the difference between JFM and controls was only observed at the forehead, the intensity of pain produced by the pressure algometry at both sites was significantly higher in the JFM participants compared with controls. Correlations between clinical pain and anxiety were significant for the JFM group only. No relationships were observed between anxiety and pressure pain for either group.

Discussion: This study is a first step toward investigating mechanisms of altered pain processing in adolescents with JFM. Adolescents with JFM were found be more sensitive to pressure pain than their healthy peers, which suggests a propensity for sensitization of peripheral and/or central nociceptive information often reported in adult fibromyalgia, and which does not appear to be affected by anxiety.

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References

Clauw D, Williams D, Lauerman W, Dahlman M, ASLAMI A, Nachemson A . Pain sensitivity as a correlate of clinical status in individuals with chronic low back pain. Spine (Phila Pa 1976). 1999; 24(19):2035-41. DOI: 10.1097/00007632-199910010-00013. View

Duarte M, Goulart E, Penna F . Pressure pain threshold in children with recurrent abdominal pain. J Pediatr Gastroenterol Nutr. 2000; 31(3):280-5. DOI: 10.1097/00005176-200009000-00015. View

Staud R, Vierck C, Cannon R, Mauderli A, Price D . Abnormal sensitization and temporal summation of second pain (wind-up) in patients with fibromyalgia syndrome. Pain. 2001; 91(1-2):165-75. DOI: 10.1016/s0304-3959(00)00432-2. View

Farrar J, Young Jr J, Lamoreaux L, Werth J, Poole M . Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001; 94(2):149-158. DOI: 10.1016/S0304-3959(01)00349-9. View

White K, Nielson W, Harth M, Ostbye T, Speechley M . Chronic widespread musculoskeletal pain with or without fibromyalgia: psychological distress in a representative community adult sample. J Rheumatol. 2002; 29(3):588-94. View

Treede R, Rolke R, Andrews K, Magerl W . Pain elicited by blunt pressure: neurobiological basis and clinical relevance. Pain. 2002; 98(3):235-240. DOI: 10.1016/S0304-3959(02)00203-8. View

Price D, Staud R, Robinson M, Mauderli A, Cannon R, Vierck C . Enhanced temporal summation of second pain and its central modulation in fibromyalgia patients. Pain. 2002; 99(1-2):49-59. DOI: 10.1016/s0304-3959(02)00053-2. View

Petzke F, Gracely R, Park K, Ambrose K, Clauw D . What do tender points measure? Influence of distress on 4 measures of tenderness. J Rheumatol. 2003; 30(3):567-74. View

Petzke F, Clauw D, Ambrose K, Khine A, Gracely R . Increased pain sensitivity in fibromyalgia: effects of stimulus type and mode of presentation. Pain. 2003; 105(3):403-413. DOI: 10.1016/S0304-3959(03)00204-5. View

10.

Conte P, Walco G, Kimura Y . Temperament and stress response in children with juvenile primary fibromyalgia syndrome. Arthritis Rheum. 2003; 48(10):2923-30. DOI: 10.1002/art.11244. View

11.

Keller S, Bann C, Dodd S, Schein J, Mendoza T, Cleeland C . Validity of the brief pain inventory for use in documenting the outcomes of patients with noncancer pain. Clin J Pain. 2004; 20(5):309-18. DOI: 10.1097/00002508-200409000-00005. View

12.

Petzke F, Harris R, Williams D, Clauw D, Gracely R . Differences in unpleasantness induced by experimental pressure pain between patients with fibromyalgia and healthy controls. Eur J Pain. 2005; 9(3):325-35. DOI: 10.1016/j.ejpain.2004.09.001. View

13.

Zohsel K, Hohmeister J, Oelkers-Ax R, Flor H, Hermann C . Quantitative sensory testing in children with migraine: preliminary evidence for enhanced sensitivity to painful stimuli especially in girls. Pain. 2006; 123(1-2):10-8. DOI: 10.1016/j.pain.2005.12.015. View

14.

Geisser M, Gracely R, Giesecke T, Petzke F, Williams D, Clauw D . The association between experimental and clinical pain measures among persons with fibromyalgia and chronic fatigue syndrome. Eur J Pain. 2006; 11(2):202-7. DOI: 10.1016/j.ejpain.2006.02.001. View

15.

Schenk P, Laeubli T, Klipstein A . Validity of pressure pain thresholds in female workers with and without recurrent low back pain. Eur Spine J. 2006; 16(2):267-75. PMC: 2200678. DOI: 10.1007/s00586-006-0124-x. View

16.

Pukall C, Baron M, Amsel R, Khalife S, Binik Y . Tender point examination in women with vulvar vestibulitis syndrome. Clin J Pain. 2006; 22(7):601-9. DOI: 10.1097/01.ajp.0000210903.67849.af. View

17.

Kashikar-Zuck S, Lynch A, Graham T, Swain N, Mullen S, Noll R . Social functioning and peer relationships of adolescents with juvenile fibromyalgia syndrome. Arthritis Rheum. 2007; 57(3):474-80. DOI: 10.1002/art.22615. View

18.

Kashikar-Zuck S, Parkins I, Graham T, Lynch A, Passo M, Johnston M . Anxiety, mood, and behavioral disorders among pediatric patients with juvenile fibromyalgia syndrome. Clin J Pain. 2008; 24(7):620-6. PMC: 3711138. DOI: 10.1097/AJP.0b013e31816d7d23. View

19.

Moulton E, Burstein R, Tully S, Hargreaves R, Becerra L, Borsook D . Interictal dysfunction of a brainstem descending modulatory center in migraine patients. PLoS One. 2008; 3(11):e3799. PMC: 2582961. DOI: 10.1371/journal.pone.0003799. View

20.

Blankenburg M, Boekens H, Hechler T, Maier C, Krumova E, Scherens A . Reference values for quantitative sensory testing in children and adolescents: developmental and gender differences of somatosensory perception. Pain. 2010; 149(1):76-88. DOI: 10.1016/j.pain.2010.01.011. View