Gender differences among patients with fibromyalgia undergoing multidisciplinary pain rehabilitation

Abstract

Objective: This study was conducted to test the hypothesis that gender differences in physical and emotional functioning are present among patients with fibromyalgia undergoing multidisciplinary pain rehabilitation.

Design: Retrospective case-matched series. Setting. Multidisciplinary pain rehabilitation center at a tertiary referral medical center.

Patients: Thirty-three consecutive men with fibromyalgia admitted from January 2002 through June 2005 were matched to 33 women with fibromyalgia for age, treatment dates, and program completion status. Interventions. A 3-week outpatient multidisciplinary pain rehabilitation program based on a cognitive-behavioral model that incorporates analgesic medication withdrawal.

Outcome measures: Multidimensional Pain Inventory (MPI), Short Form-36 Health Status Questionnaire (SF-36), Coping Strategies Questionnaire-Catastrophizing subscale (CSQ-C), and the Center for Epidemiologic Studies-Depression scale (CES-D) were administered before and after treatment. The numbers of patients using opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and benzodiazepines before and after treatment were compared.

Results: Pretreatment MPI and SF-36 scores revealed men had lower health perception (P = 0.017) and more physical limitations (P = 0.004) while women had greater life interference due to pain (P = 0.005). Mean differences in all pre- and post-treatment outcome measures demonstrated a statistically significant treatment response. However, men had lower post-treatment scores on the SF-36 health perception (P = 0.023), role limitations-physical (P = 0.021), and social functioning (P = 0.033) subscales. Significant within-gender reductions in opioid analgesic, NSAID, and benzodiazepine use were observed but no significant between-gender differences were identified.

Conclusions: These results support the hypothesis that pretreatment gender differences are present among fibromyalgia patients undergoing multidisciplinary pain rehabilitation and post-treatment gender differences persist despite improvements in physical and emotional functioning.