Clinical Features and Psychologic Factors in Regional Soft Tissue Pain: Comparison with Fibromyalgia Syndrome

SUMMARY

Objectives: Regional soft tissue pain [RSTP] is characterized by soft tissue pain involving one or limited contiguous sites, as well as one or more tender points [TPs]. Regional soft tissue pain and fibromyalgia syndrome [FMS] have overlapping symptoms, but detailed comparison data are absent. In this study, we evaluated clinical features and psychological factors in RSTP and compared them with those in FMS and normal controls [NC].

Methods: Ninety-one patients with RSTP and 630 patients with FMS who were consecutively seen in a university rheumatology clinic, as well as 166 healthy pain-free NC, were included in the study. Clinical and psychological features were evaluated by a protocol. Anxiety and depression were also assessed by Spielberger State and Trait Anxiety Inventory [STAI] and Zung Depression Scale [ZDS], respectively.

Results: All clinical and psychological features were significantly more common in RSTP than NC, with the exception of irritable bowel syndrome [IBS], global stress and depression. All clinical features, including TPs at 18 American College of Rheumatology sites, were less common or fewer in RSTP than FMS at the level of P < 0.001, with the exception of paresthesia [P < 0.03], as well as pain and patient-assessed global severity [P > 0.05]. While self-assessed global anxiety, stress and depression were less common [P < 0.001] in RSTP than FMS, the STAI anxiety and ZDS depression scores were similar in these two groups.

Conclusion: Regional soft tissue pain and FMS share many clinical and psychological features. However, several features, including poor sleep, fatigue, IBS, paresthesia, swollen feeling, headaches and number of TPs are significantly less frequent or fewer among patients with RSTP than FMS.

KEYWORDS:

• Regional soft tissue pain
• fibromyalgia syndrome
• clinical features
• psychological factors