A simple screening test to recognize fibromyalgia in primary care patients with chronic pain

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Created On: 18/02/2020

A simple screening test to recognize fibromyalgia in primary care patients with chronic pain

Primary care providers are more demanded to diagnose and manage fibromyalgia (FM) without notable interaction with rheumatologists.

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Key take away

Diagnosis of fibromyalgia (FM) is a complicated process, and it may take 2 to 3 years, with many patients seeing 3 to 4 medical providers before receiving the correct diagnosis. Therefore, clinicians need a simple screening test that can be performed as part of the routine evaluation in all patients. The present result suggested that two tests, taking less than 1 minute, can indicate a probable diagnosis of FM in a chronic pain patient.

Background

Primary care providers are more demanded to diagnose and manage fibromyalgia (FM) without notable interaction with rheumatologists. The goal of this analysis was to assess the potential use of 3 simple measures (BP cuff-evoked pain, a single patient question, and tenderness to digital pressure) as a screening test for possible FM within a patient suffering from chronic pain.

Method

Three hundred twenty-five participants registered for a routine checkup. Out of these, 192 present neither pain nor FM, 108 showed pain but not FM, and 52 found to have FM. Patients were evaluated for BP cuff-evoked pain, tenderness to digital pressure at 10 locations, and a single question, "I have a persistent deep aching over most of my body".

Result

FM patients supported the single deep ache question considerably more than those with chronic pain but without FM and presented larger bilateral digital evoked tenderness and BP-evoked pressure pain. Although, the BP cuff-evoked pain turned out to be non-significant on multivariate logistic regressions. On further investigations, a valuable screening test was presented by (1) pain on pressing the Achilles tendon at 4kg/pressure above 4 seconds, and (2) and positive support of the question "I have a severe deep aching over most of my body".

Conclusion

These outcomes recommend that two tests, at less than 1 minute, can show a probable diagnosis of FM within a chronic pain patient. During the positive screen, a follow-up analysis is wanted for acceptance or refusal.