Repetition-induced activity-related summation of pain in patients with fibromyalgia

Department of Psychology, University of Montreal, Montreal, QC, Canada.
Pain (Impact Factor: 5.64). 03/2011; 152(6):1424-30. DOI: 10.1016/j.pain.2011.02.030
Source: PubMed

ABSTRACT This study compared individuals with fibromyalgia (FM) and individuals with chronic low back pain (CLBP) on repetition-induced summation of activity-related pain (RISP). Fear of movement, pain catastrophizing and depression were examined as potential mediators of group differences. The sample consisted of 50 women with FM and 50 women with CLBP who were matched on age, pain severity and pain duration. Participants were asked to lift a series of 18 weighted canisters. In one trial, participants were asked to rate their pain after each lift. In a second trial, participants estimated the weight of each of the canisters. An index of repetition-induced summation of pain was derived as the change in pain ratings across repeated lifts. Analyses revealed that women with FM obtained higher scores on the index of RISP than women with CLBP. The heightened sensitivity to RISP in individuals with FM was not due to generalized hyperalgesia or a greater work output. Consistent with previous research, fear of movement was positively correlated with RISP. Pain disability was also associated with greater RISP, but not pain catastrophizing or depression. Discussion addresses the processes by which individuals with FM might have increased RISP responses. The findings of this study point to possible neurophysiological mechanisms that could help explain the high levels of pain-related disability seen in individuals with FM. Patients with fibromyalgia showed greater activity-related summation of pain than patients with chronic low back pain.

  • [Show abstract] [Hide abstract]
    ABSTRACT: This study sought to determine whether repetition-induced summation of activity-related pain (RISP) could be demonstrated in healthy individuals in response to experimentally induced musculoskeletal pain. This study also assessed the effects of transcutaneous electrical nerve stimulation on RISP. The relation between the index of RISP and psychological factors such as catastrophizing and fear of pain was also explored. The sample consisted of 56 healthy (35 women, 21 men) participants who underwent 2 testing sessions, separated by 24 hours. In the first session, musculoskeletal pain was induced with a delayed-onset muscle soreness protocol. During the second session, participants were randomly assigned to the transcutaneous electrical nerve stimulation or placebo condition and were asked to rate their pain as they lifted a series of 18 weighted canisters. An index of RISP was derived as the change in pain ratings across repeated lifts. Approximately 25% of participants showed evidence of RISP. Results also revealed that transcutaneous electrical nerve stimulation attenuated the RISP effect. Psychological measures (fear of pain, catastrophizing) were not significantly correlated with the index of RISP, but the index of RISP was significantly correlated with a measure of physical tolerance. Discussion addresses the clinical implications of the findings as well as the potential mechanisms underlying RISP. This study showed that RISP could be demonstrated in healthy individuals in response to experimentally induced musculoskeletal pain with delayed-onset muscle soreness. Transcutaneous electrical nerve stimulation led to a significant reduction in RISP.
    The journal of pain: official journal of the American Pain Society 11/2013; 14(11):1416-24. DOI:10.1016/j.jpain.2013.07.019 · 4.22 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Cognitive and behavioral impairments are core manifestations of fibromyalgia and may be more disabling than pain itself. Involvement of the central nervous system is ascertained by the fact that frontoparietal and limbic cortices are often functionally and structurally affected along the course of this disease. Even though neuroimaging has brought some experimental evidence to support such network disruption, there are currently no clinically effective biomarkers that detect and quantify cognitive and behavioral disturbances in fibromyalgia; thus, traditional scales and tests of neuropsychiatric assessment remain the most important diagnostic tools. This review addresses the most common cognitive and behavioral impairments in people with fibromyalgia, while explaining their pathophysiological basis and currently available therapeutic options.
    Current Pain and Headache Reports 07/2013; 17(7):344. DOI:10.1007/s11916-013-0344-9 · 2.26 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Recent findings suggest that certain individuals with musculoskeletal pain conditions have increased Sensitivity to Physical Activity (SPA) and respond to activities of stable intensity with increasingly severe pain. This study aimed to determine the degree to which individuals with knee OA show heightened SPA in response to a standardized walking task and whether SAP cross-sectionally predicts psychological factors, responses to Quantitative Sensory Testing (QST) and different OA-related outcomes. 107 adults with chronic knee osteoarthritis completed self-report measures of pain, function and psychological factors, underwent QST and performed a 6-minute walk test. Participants rated their discomfort levels throughout the walking task; an index of SPA was created by subtracting first ratings from peak ratings. Repeated measures analysis of variance revealed that levels of discomfort significantly increased throughout the walking task. A series of hierarchical regression analyses determined that after controlling for significant covariates, psychological factors and measures of mechanical pain sensitivity, individual variance in SPA predicted self-report pain and function and performance on the walking task. Analyses also revealed that both pain catastrophizing and the temporal summation of mechanical pain were significant predictors of SPA and that SPA mediated the relationship between catastrophizing and self-reported pain and physical function. The discussion addresses the potential processes contributing to SPA and the role it may play in predicting responses to different interventions for musculoskeletal pain conditions.
    Pain 12/2013; 155(4). DOI:10.1016/j.pain.2013.12.028 · 5.64 Impact Factor

Full-text (2 Sources)

Available from
May 19, 2014