Both FM and CBP are thought to, in part, involve central sensitization and inoperative descending pain inhibition. Their histories are however different.
Pain Med. 2012 Dec;13(12):1562-70.
Representations of Symptom History in Women with Fibromyalgia vs Chronic Low Back Pain: A Qualitative Study.
Cedraschi C, Luthy C, Girard E, Piguet V, Desmeules J, Allaz AF.
They were discussed in 5 realms: “psychological issues, somatic concerns, occupational problems, diagnostic issues, and issues related to chronicity.”
- Psychological issues – psychological distress presents as sadness/hopelessness in 45% of FM cases but not in CBP cases at all. I’ve heard it described as dread of the future.
- Prior psychological trauma is seen in the FM group – childhood abuse (18 vs 7%), death of a relative (36 vs 3%), divorce (16% vs none), and some form of psychololgical shock (30% vs none). Often the psychological distress is relational
- Interestingly, a prior history of hyperactivity was seen in 39% of FM but not at all in CBP cases.
- FM cases referred to Obstetrical and Gynecological events predating thier pains. I highly suspect gyecological surgery (largest concentration of nerves is in the pelvis) causing psoas spasm, posture imbalances and so forth as part of it. A recent article suspected widespread chronic pain at term was more common than realized:
Rheumatol Int. 2012 Dec 22. [Epub ahead of print]
High prevalence of fibromyalgia symptoms among healthy full-term pregnant women.
Saa’d S, Many A, Jacob G, Ablin JN. abstract here
27% qualified as having FM symptoms at term
Also:
A study on the prevalence of pain 1 year after delivery found 6-18% after C-section and 4-8% after vaginal delivery:
Curr Opin Anaesthesiol. 2010 Jun;23(3):295-9.
Prevalence and predictors of chronic pain after labor and delivery.
Vermelis JM, Wassen MM, Fiddelers AA, Nijhuis JG, Marcus MA. abstract here - CBP cases were more likely to have a history of an accident (45% vs 25%)
- FM cases were more likel,y to have an issue following “gynecological/obstetrical events” – 29 versius 10%
- Fatigue is over twice as common in FM vs CBP (29 vs 13%) but of course that helped define them as having Fibromyalgia
- FM is an enigma mystery and is a diagnosis of exclusion so 52% had other diagnosis evoked before the diagnosis was made versus 0% for CBP – a very frustrating circumstance.
- For over 3/4 of each, it was and evolving non-curable chronic disease, but in FM it was much more likely to be a spreading disease (64% vs 0% )
- Study points out how subject with FM, like Rodney Dangerfield, “get no respect”. In a study of stimatized illnesses, only Cirrrhosis of liver (often alcoholic), anxiety neurosis, and HIV faired as bad:
Album D, Westin S.
Do diseases have a prestige hierarchy? A survey among physicians and medical students.
Soc Sci Med 2008;66:182–8. abstract here
Comment – The onset wilth overwhelming psychological stress or Obstetrical/gynecological conditions separates it apart form CBP. That, and its ability to spread, suggests more central brain malfunction is involved but that is as far as I can conclude.
Would be interested in sufferer’s perspectives…