Fibromyalgia and Spine Pain

Spine pain may have fibromyalgia

(RxWiki News) You're in pain. Your neck and back constantly hurt. But how do you know if your pain is just pain, or if it's fibromyalgia?

If standard treatments for neck and back pain don't help, you might have fibromyalgia. People with fibromyalgia have chronic, widespread pain that is different from common spine pain.

A new study found that a significant number of patients being treated for neck and back pain actually fit the criteria for fibromyalgia, and require different treatment.

" If treatment isn't helping your back pain, ask your doctor about fibromyalgia."

Dr. Chad Brummet, director of adult pain research at the University of Michigan Back and Pain Center in Ann Arbor, led the study. He is interested in differentiating between different types of pain when the patient seeks care. It could mean more effective treatment for the patient who is suffering from pain.

Most patients who complain of axial spine pain, or neck and back pain, are treated with painkillers. Recently, there's been an increase in the number of epidural or facet injections as treatment for spine pain. These treatments are intended to provide temporary relief from pain.

However, 39 to 47 percent of facet injections fail to work on patients, and it is common that pain persists. It's thought that the widespread pain experienced by fibromyalgia patient comes from dysfunction in the central nervous system, as opposed to a single site of pain, which is more common.

Dr. Brummet suggested that if patients who complain of back and neck pain actually have fibromyalgia, it may explain why they don't respond to the standard treatment.

The study surveyed 166 patients who came into a pain clinic at the University of Michigan. They answered several questionnaires intended to assess their pain. They were also evaluated for fibromyalgia, and reported the efficacy of their previous treatments for pain.

It turned out that 43.4 percent of the patients met the criteria for fibromyalgia. Compared to the patients who did not test positive for the condition, they had greater pain intensity and interference, as well as higher levels of depression and anxiety.

More of the patients who met the criteria for fibromyalgia were taking opioid painkillers than patients who did not meet the criteria. The first group rated the painkillers as less effective than the second group did, but the difference was not significant. However, injections were judged to be significantly less effective than for those with fibromyalgia symptoms than those who did not.

Dr. Brummet's study concluded that many patients with spine pain who meet the criteria for fibromyalgia may have altered central pain processing that does not respond to opioid or injections. If a patient tests positive for fibromyalgia, it's a predictor that these treatments will likely not work. In addition, because people with fibromyalgia are more likely to have depression or anxiety, a treatment strategy should address those symptoms as well.

The study was presented at the American Society of Anesthesiologists Annual Meeting in 2011.

Review Date: 
November 29, 2011