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. 2018 Oct;34(10):909-917.
doi: 10.1097/AJP.0000000000000619.

Association Between the 2011 Fibromyalgia Survey Criteria and Multisite Pain Sensitivity in Knee Osteoarthritis

Stephen J Neville  1 , Andrew D Clauw  2 , Stephanie E Moser  2 , Andrew G Urquhart  3 , Daniel J Clauw  2   4 , Chad M Brummett  2 , Steven E Harte  2   4
Affiliations

Association Between the 2011 Fibromyalgia Survey Criteria and Multisite Pain Sensitivity in Knee Osteoarthritis

Stephen J Neville et al. Clin J Pain. 2018 Oct.

Abstract

Objectives: The present study evaluated the relationship between the 2011 American College of Rheumatology fibromyalgia (FM) survey criteria and quantitative sensory testing (QST).

Materials and methods: Patients with knee osteoarthritis scheduled to undergo knee arthroplasty completed the FM survey criteria and self-report measures assessing clinical symptoms. Patients also underwent a battery of QST procedures at the surgical knee and remote body sites, including pressure algometry, conditioned pain modulation, and temporal summation. All assessments were completed before surgery. FM survey criteria were used to calculate a continuous FM score indicating FM severity.

Results: A total of 129 patients were analyzed. Of these, 52.7% were female, 93.8% were Caucasian, and 3.8% met the FM survey criteria for FM classification. Mean age for females (63.6 y) and males (64.7 y) was similar. Females and males differed significantly in nearly every outcome, including FM severity, clinical pain, anxiety, depression, and pressure pain sensitivity. In females, FM scores significantly correlated with pressure pain sensitivity, but not conditioned pain modulation or temporal summation, such that increased sensitivity was associated with greater FM severity at all body sites examined. In addition, as FM scores increased, the association between pain sensitivity at the surgical knee and pain sensitivity at remote body sites also increased. No relationship between FM score and QST was observed in males.

Discussion: We demonstrated an association between diffuse hyperalgesia as measured by QST and FM severity in females with knee osteoarthritis. These results suggest that the FM survey criteria may represent a marker of pain centralization in females with potential utility in clinical decision making.

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Conflict of interest statement

Conflicts of Interest

Stephen Neville, Andrew Urquhart, Andrew Clauw, and Stephanie Moser report no competing interests to declare.

Figures

Figure 1
Figure 1
CONSORT flow diagram of patient enrollment patterns. Patients analyzed here completed both baseline Light phenotyping as well as Deep phenotyping, which included quantitative sensory testing.
Figure 2
Figure 2
Pressure pain thresholds (PPT) assessed at four body sites exhibit a stepwise increase in pain sensitivity (lower thresholds) across fibromyalgia (FM) score tertiles. * ≤ 0.011 compared to Low FM. # = 0.042 compared to Low FM.
Figure 3
Figure 3
Associations between pressure pain thresholds (PPT) as a function of FM score tertile. Spearman’s correlations between surgical knee PPT and PPTs measured at the lower leg, wrist, and trapezius become stronger as FM score increases.
See this image and copyright information in PMC

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