Tender points as predictors of distress and the pharmacologic management of fibromyalgia syndrome.
The object of this study was to determine the association between tender point pain ratings, tender point counts and distress in people with fibromyalgia and to review the pharmacotherapy of fibromyalgia. Demographic, psychosocial, and health status information was collected from 316 health maintenance organization members with fibromyalgia. A manual tender point exam was conducted. Tender point counts predicted 3.0%, and tender point severity ratings predicted 8.3%, of the variance in distress. Little difference was found between the variance predicted for physical versus psychologic distress. A principal components analysis of all measures produced four distinct factors: global-physical functioning, tender points, psychologic, and physical. Tender point pain ratings and counts predicted a small but significant amount of variance in distress. In addition, FMS involves at least four rather distinct factors, one of which is related to tender points. Pharmacotherapeutic management is provided on a patient-specific basis including pharmacokinetics, pharmacodynamic, pathophysiologic, and psychosocial needs designed and modulated for each individual patient.
McCarberg
Bill
B
Kaiser Permanente, San Diego State University, San Diego, CA, USA. bill.h.mccarberg@kp.org
Barkin
Robert L
RL
Wright
Julie A
JA
Cronan
Terry A
TA
Groessl
Erik
E
Schmidt
Steven M
SM
D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use; D005260:Female; D005356:Fibromyalgia / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D010147:Pain Measurement / Q000379:methods; D017288:Pain Threshold; D010173:Palpation; D011985:Receptors, Serotonin / Q000627:therapeutic use; D015203:Reproducibility of Results; D012702:Serotonin Antagonists / Q000627:therapeutic use; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States
D000700:Analgesics; D000928:Antidepressive Agents; D016861:Cyclooxygenase Inhibitors; D011985:Receptors, Serotonin; D012702:Serotonin Antagonists