Ten Brink Antonia F, Peters Louisa, Kompouli Paraskevi-Ioanna, Jordan Abbie, McCabe Candida S, Goebel Andreas, Bultitude Janet H
Department of Psychology, University of Bath, Bath, United Kingdom.
Centre for Pain Research, University of Bath, Bath, United Kingdom.
Pain. 2020 Jun;161(6):1361-1370. doi: 10.1097/j.pain.0000000000001830.
Complex regional pain syndrome (CRPS) and fibromyalgia are chronic pain conditions of unexplained origins. In addition to symptoms in the diagnostic criteria, patients can report changes to vision and other sensations or bodily functions. It is unclear whether these are greater than would be expected due to normal ageing, living with chronic pain generally, or common comorbidities of chronic pain such as depression or anxiety. We administered an on-line survey evaluating the frequencies and types of self-reported somatic symptoms, bodily changes, and sensory sensitivity in respondents with CRPS (n = 390), fibromyalgia (n = 425), and both CRPS and fibromyalgia ("CRPS+fibromyalgia"; n = 88) compared to respondents with other chronic pain conditions (n = 331) and pain-free controls (n = 441). The survey assessed somatic symptoms (Patient Health Questionnaire-15), bodily changes, pain/discomfort/distress triggers, and pain intensifiers. We conducted analysis of covariance's with age, sex, Patient Health Questionnaire-9 (measuring depression), Generalized Anxiety Disorder-7, pain duration in years, hours of pain per day, and number of pain-related medical diagnoses as covariates. After controlling for covariates, respondents with CRPS and/or fibromyalgia reported more somatic symptoms, changes in movement and biological responses, pain/discomfort/distress triggers, and pain intensifiers than pain(-free) control groups. Fibromyalgia specifically related to changes in vision and hearing, urinary/intestinal function, and drinking and eating. Complex regional pain syndrome related to changes in hair, skin, and nails; and infection and healing. The CRPS+fibromyalgia group presented with features of both disorders with minimal additional stressors or symptoms over and above these. Our findings suggest that CRPS and fibromyalgia share underlying pathophysiologies, although specific mechanisms might be different.
复杂性区域疼痛综合征（CRPS）和纤维肌痛是病因不明的慢性疼痛病症。除了诊断标准中的症状外，患者还可能报告视力及其他感觉或身体功能的变化。目前尚不清楚这些变化是否超过了正常衰老、一般慢性疼痛患者或慢性疼痛常见合并症（如抑郁或焦虑）所预期的范围。我们进行了一项在线调查，评估了CRPS患者（n = 390）、纤维肌痛患者（n = 425）以及同时患有CRPS和纤维肌痛（“CRPS + 纤维肌痛”；n = 88）的受访者与其他慢性疼痛患者（n = 331）和无疼痛对照组（n = 441）相比，自我报告的躯体症状、身体变化和感觉敏感性的频率及类型。该调查评估了躯体症状（患者健康问卷 - 15）、身体变化、疼痛/不适/痛苦触发因素和疼痛加剧因素。我们以年龄、性别、患者健康问卷 - 9（测量抑郁）、广泛性焦虑障碍 - 7、疼痛持续年限、每日疼痛小时数以及与疼痛相关的医学诊断数量作为协变量进行协方差分析。在控制协变量后，患有CRPS和/或纤维肌痛患者报告的躯体症状、运动和生物学反应变化、疼痛/不适/痛苦触发因素以及疼痛加剧因素比无疼痛对照组更多。纤维肌痛尤其与视力和听力变化、泌尿/肠道功能以及饮食有关。复杂性区域疼痛综合征与毛发、皮肤和指甲变化以及感染和愈合有关。CRPS + 纤维肌痛组呈现出两种病症的特征，且除此之外几乎没有额外的应激源或症状。我们的研究结果表明，CRPS和纤维肌痛具有共同的潜在病理生理学机制，尽管具体机制可能不同。
