Impact of Moving From a Widespread to Multisite Pain Definition on Other Fibromyalgia Symptoms

Linda E. Dean, Lesley Arnold, Leslie Crofford, Robert Bennett, Don Goldenberg, Mary-Ann Fitzcharles, Eduardo S. Paiva, Roland Staud, Dan Clauw, Piercarlo Sarzi-Puttini, Gareth T. Jones, Abimbola Ayorinde, Elisa Fluß, Marcus Beasley, Gary J. Macfarlane

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Abstract

OBJECTIVES: The current study investigated whether associations between pain and the additional symptoms associated with fibromyalgia are different in persons with chronic widespread (CWP) compared to multi-site pain (MSP), with or without joint areas.

PATIENTS/METHODS: Six studies were utilized: 1958 British birth cohort, EpiFunD, Kid LBP, MUSICIAN, SHAMA and WHEST (females) studies. MSP was defined as the presence of pain in ≥8/≥10 body sites (adults/children) indicated on 4-view body manikins; conducted firstly to include joints (+joints) and secondly without (-joints). The relationship between pain and fatigue, sleep disturbance, somatic symptoms and mood impairment, were assessed using logistic regression. Results are presented as odds ratios (OR), with 95% confidence intervals (CI).

RESULTS: There were 34,818 participants across the study populations (adults: mean age range 42-56yrs, % male 43-51 (excluding WHEST), CWP prevalence 12-17%). Amongst those reporting MSP, the proportion reporting CWP ranged between 62-76%. Amongst those reporting the symptoms associated with fibromyalgia, there was an increased likelihood of reporting pain, the magnitude of which were similar regardless of definition used. For example, within WHEST; reporting moderate/severe fatigue (Chalder fatigue scale 4-11) was associated with over a 5-fold increase in likelihood of reporting pain [CWP OR 5.2, 95%CI 3.9-6.9; MSP+joints 6.5, 5.0-8.6; MSP-joints 6.5, 4.7-9.0].

DISCUSSION: This large-scale study demonstrates that, regardless of pain definition used, the magnitude of association between pain and other associated symptoms of fibromyalgia are similar. This supports the continued collection of both when classifying fibromyalgia but highlights that pain may not require to follow the definition outlined within the 1990ACR criteria.

Original languageEnglish
Pages (from-to)1878-1886
Number of pages9
JournalArthritis Care & Research
Volume69
Issue number12
Early online date2 Nov 2017
DOIs
Publication statusPublished - Dec 2017

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Fibromyalgia
Pain
Joints
Fatigue
Arthralgia
Odds Ratio
Confidence Intervals
Manikins
Chronic Pain
Sleep
Logistic Models
Parturition

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Impact of Moving From a Widespread to Multisite Pain Definition on Other Fibromyalgia Symptoms. / Dean, Linda E.; Arnold, Lesley; Crofford, Leslie; Bennett, Robert; Goldenberg, Don; Fitzcharles, Mary-Ann; Paiva, Eduardo S.; Staud, Roland; Clauw, Dan; Sarzi-Puttini, Piercarlo; Jones, Gareth T.; Ayorinde, Abimbola; Fluß, Elisa; Beasley, Marcus; Macfarlane, Gary J.

In: Arthritis Care & Research, Vol. 69, No. 12, 12.2017, p. 1878-1886.

Research output: Contribution to journalArticle

Dean, LE, Arnold, L, Crofford, L, Bennett, R, Goldenberg, D, Fitzcharles, M-A, Paiva, ES, Staud, R, Clauw, D, Sarzi-Puttini, P, Jones, GT, Ayorinde, A, Fluß, E, Beasley, M & Macfarlane, GJ 2017, 'Impact of Moving From a Widespread to Multisite Pain Definition on Other Fibromyalgia Symptoms', Arthritis Care & Research, vol. 69, no. 12, pp. 1878-1886. https://doi.org/10.1002/acr.23214
Dean, Linda E. ; Arnold, Lesley ; Crofford, Leslie ; Bennett, Robert ; Goldenberg, Don ; Fitzcharles, Mary-Ann ; Paiva, Eduardo S. ; Staud, Roland ; Clauw, Dan ; Sarzi-Puttini, Piercarlo ; Jones, Gareth T. ; Ayorinde, Abimbola ; Fluß, Elisa ; Beasley, Marcus ; Macfarlane, Gary J. / Impact of Moving From a Widespread to Multisite Pain Definition on Other Fibromyalgia Symptoms. In: Arthritis Care & Research. 2017 ; Vol. 69, No. 12. pp. 1878-1886.
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abstract = "OBJECTIVES: The current study investigated whether associations between pain and the additional symptoms associated with fibromyalgia are different in persons with chronic widespread (CWP) compared to multi-site pain (MSP), with or without joint areas.PATIENTS/METHODS: Six studies were utilized: 1958 British birth cohort, EpiFunD, Kid LBP, MUSICIAN, SHAMA and WHEST (females) studies. MSP was defined as the presence of pain in ≥8/≥10 body sites (adults/children) indicated on 4-view body manikins; conducted firstly to include joints (+joints) and secondly without (-joints). The relationship between pain and fatigue, sleep disturbance, somatic symptoms and mood impairment, were assessed using logistic regression. Results are presented as odds ratios (OR), with 95{\%} confidence intervals (CI).RESULTS: There were 34,818 participants across the study populations (adults: mean age range 42-56yrs, {\%} male 43-51 (excluding WHEST), CWP prevalence 12-17{\%}). Amongst those reporting MSP, the proportion reporting CWP ranged between 62-76{\%}. Amongst those reporting the symptoms associated with fibromyalgia, there was an increased likelihood of reporting pain, the magnitude of which were similar regardless of definition used. For example, within WHEST; reporting moderate/severe fatigue (Chalder fatigue scale 4-11) was associated with over a 5-fold increase in likelihood of reporting pain [CWP OR 5.2, 95{\%}CI 3.9-6.9; MSP+joints 6.5, 5.0-8.6; MSP-joints 6.5, 4.7-9.0].DISCUSSION: This large-scale study demonstrates that, regardless of pain definition used, the magnitude of association between pain and other associated symptoms of fibromyalgia are similar. This supports the continued collection of both when classifying fibromyalgia but highlights that pain may not require to follow the definition outlined within the 1990ACR criteria.",
author = "Dean, {Linda E.} and Lesley Arnold and Leslie Crofford and Robert Bennett and Don Goldenberg and Mary-Ann Fitzcharles and Paiva, {Eduardo S.} and Roland Staud and Dan Clauw and Piercarlo Sarzi-Puttini and Jones, {Gareth T.} and Abimbola Ayorinde and Elisa Flu{\ss} and Marcus Beasley and Macfarlane, {Gary J.}",
note = "We would like to thank the investigators of the 1958 British birth cohort, EpiFunD, Kid LBP, MUSICIAN, SHAMA and WHEST studies, for providing the data necessary for the current analysis. Additionally we acknowledge the funders of these studies, namely the Medical Research Council (1958 British birth cohort – biomedical research survey), Arthritis Research UK (EpiFunD, MUSICIAN), Colt Foundation (Kid LBP), British Pain Society – Mildred Clulow Award (WHEST) and National Health Service Grampian (WHEST). Lastly, we wish to thank the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) initiative which provided funding for the current analysis.",
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T1 - Impact of Moving From a Widespread to Multisite Pain Definition on Other Fibromyalgia Symptoms

AU - Dean, Linda E.

AU - Arnold, Lesley

AU - Crofford, Leslie

AU - Bennett, Robert

AU - Goldenberg, Don

AU - Fitzcharles, Mary-Ann

AU - Paiva, Eduardo S.

AU - Staud, Roland

AU - Clauw, Dan

AU - Sarzi-Puttini, Piercarlo

AU - Jones, Gareth T.

AU - Ayorinde, Abimbola

AU - Fluß, Elisa

AU - Beasley, Marcus

AU - Macfarlane, Gary J.

N1 - We would like to thank the investigators of the 1958 British birth cohort, EpiFunD, Kid LBP, MUSICIAN, SHAMA and WHEST studies, for providing the data necessary for the current analysis. Additionally we acknowledge the funders of these studies, namely the Medical Research Council (1958 British birth cohort – biomedical research survey), Arthritis Research UK (EpiFunD, MUSICIAN), Colt Foundation (Kid LBP), British Pain Society – Mildred Clulow Award (WHEST) and National Health Service Grampian (WHEST). Lastly, we wish to thank the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) initiative which provided funding for the current analysis.

PY - 2017/12

Y1 - 2017/12

N2 - OBJECTIVES: The current study investigated whether associations between pain and the additional symptoms associated with fibromyalgia are different in persons with chronic widespread (CWP) compared to multi-site pain (MSP), with or without joint areas.PATIENTS/METHODS: Six studies were utilized: 1958 British birth cohort, EpiFunD, Kid LBP, MUSICIAN, SHAMA and WHEST (females) studies. MSP was defined as the presence of pain in ≥8/≥10 body sites (adults/children) indicated on 4-view body manikins; conducted firstly to include joints (+joints) and secondly without (-joints). The relationship between pain and fatigue, sleep disturbance, somatic symptoms and mood impairment, were assessed using logistic regression. Results are presented as odds ratios (OR), with 95% confidence intervals (CI).RESULTS: There were 34,818 participants across the study populations (adults: mean age range 42-56yrs, % male 43-51 (excluding WHEST), CWP prevalence 12-17%). Amongst those reporting MSP, the proportion reporting CWP ranged between 62-76%. Amongst those reporting the symptoms associated with fibromyalgia, there was an increased likelihood of reporting pain, the magnitude of which were similar regardless of definition used. For example, within WHEST; reporting moderate/severe fatigue (Chalder fatigue scale 4-11) was associated with over a 5-fold increase in likelihood of reporting pain [CWP OR 5.2, 95%CI 3.9-6.9; MSP+joints 6.5, 5.0-8.6; MSP-joints 6.5, 4.7-9.0].DISCUSSION: This large-scale study demonstrates that, regardless of pain definition used, the magnitude of association between pain and other associated symptoms of fibromyalgia are similar. This supports the continued collection of both when classifying fibromyalgia but highlights that pain may not require to follow the definition outlined within the 1990ACR criteria.

AB - OBJECTIVES: The current study investigated whether associations between pain and the additional symptoms associated with fibromyalgia are different in persons with chronic widespread (CWP) compared to multi-site pain (MSP), with or without joint areas.PATIENTS/METHODS: Six studies were utilized: 1958 British birth cohort, EpiFunD, Kid LBP, MUSICIAN, SHAMA and WHEST (females) studies. MSP was defined as the presence of pain in ≥8/≥10 body sites (adults/children) indicated on 4-view body manikins; conducted firstly to include joints (+joints) and secondly without (-joints). The relationship between pain and fatigue, sleep disturbance, somatic symptoms and mood impairment, were assessed using logistic regression. Results are presented as odds ratios (OR), with 95% confidence intervals (CI).RESULTS: There were 34,818 participants across the study populations (adults: mean age range 42-56yrs, % male 43-51 (excluding WHEST), CWP prevalence 12-17%). Amongst those reporting MSP, the proportion reporting CWP ranged between 62-76%. Amongst those reporting the symptoms associated with fibromyalgia, there was an increased likelihood of reporting pain, the magnitude of which were similar regardless of definition used. For example, within WHEST; reporting moderate/severe fatigue (Chalder fatigue scale 4-11) was associated with over a 5-fold increase in likelihood of reporting pain [CWP OR 5.2, 95%CI 3.9-6.9; MSP+joints 6.5, 5.0-8.6; MSP-joints 6.5, 4.7-9.0].DISCUSSION: This large-scale study demonstrates that, regardless of pain definition used, the magnitude of association between pain and other associated symptoms of fibromyalgia are similar. This supports the continued collection of both when classifying fibromyalgia but highlights that pain may not require to follow the definition outlined within the 1990ACR criteria.

U2 - 10.1002/acr.23214

DO - 10.1002/acr.23214

M3 - Article

VL - 69

SP - 1878

EP - 1886

JO - Arthritis Care & Research

JF - Arthritis Care & Research

SN - 0893-7524

IS - 12

ER -