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Pressure Pain Threshold and Anxiety in Adolescent Females With and Without Juvenile Fibromyalgia

A Pilot Study

King, Christopher D. PhD*; Jastrowski Mano, Kristen E. PhD; Barnett, Kimberly A. BS; Pfeiffer, Megan BS; Ting, Tracy V. MD§,∥; Kashikar-Zuck, Susmita PhD‡,∥

The Clinical Journal of Pain: July 2017 - Volume 33 - Issue 7 - p 620–626
doi: 10.1097/AJP.0000000000000444
Original Articles
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Objectives: Reduced pain thresholds have been documented in adult fibromyalgia, but there are no quantitative studies of altered pain sensitivity in adolescents with juvenile fibromyalgia (JFM). The current study examined differences in pressure pain sensitivity between adolescent females with JFM and healthy controls. The relationship between levels of anxiety and pain were also examined.

Methods: A total of 34 JFM (15.4±1.4 y old) and 31 controls (14.5±1.3 y old) completed self-report measures of pain and anxiety. Pressure pain threshold was assessed (palm and forehead sites) with a hand-held algometer. Participants indicated the first sensation of pain and then rated the intensity of pain on a Numerical Rating Scale.

Results: Adolescents with JFM exhibited greater sensitivity to pressure pain compared with controls. While the difference between JFM and controls was only observed at the forehead, the intensity of pain produced by the pressure algometry at both sites was significantly higher in the JFM participants compared with controls. Correlations between clinical pain and anxiety were significant for the JFM group only. No relationships were observed between anxiety and pressure pain for either group.

Discussion: This study is a first step toward investigating mechanisms of altered pain processing in adolescents with JFM. Adolescents with JFM were found be more sensitive to pressure pain than their healthy peers, which suggests a propensity for sensitization of peripheral and/or central nociceptive information often reported in adult fibromyalgia, and which does not appear to be affected by anxiety.

*Department of Pediatric Anesthesia

Division of Behavioral Medicine and Clinical Psychology

§Division of Pediatric Rheumatology, Cincinnati Children’s Hospital Medical Center

Department of Psychology, University of Cincinnati

University of Cincinnati College of Medicine, Cincinnati, OH

This work was partially supported by funding from the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health Grant K24AR056687 to S.K.-Z. The authors declare no conflict of interest.

Reprints: Christopher D. King, PhD, Department of Pediatric Anesthesia, Cincinnati Children’s Hospital Medical Center (CCHMC), 3333 Burnet Avenue, Cincinnati, OH 45229 (e-mail: Christopher.King@cchmc.org).

Received February 1, 2016

Received in revised form November 28, 2016

Accepted September 17, 2016

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