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      Chronic Widespread Pain and Fibromyalgia Syndrome: Life-Course Risk Markers in Young People

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      Author(s): 1 , 2 , 3 , 2 , 3 ,
      Publication date (Electronic):
      Journal: Pain Research & Management
      Publisher: Hindawi

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          Abstract

          Although the life-course concept of risk markers as potential etiological influences is well established in epidemiology, it has not featured in academic publications or clinical practice in the context of chronic widespread pain (CWP) and fibromyalgia syndrome (FMS). Studies of risk markers are required considerations for evaluation of patients and for research because there is no single cause, pathological feature, laboratory finding, or biomarker for CWP or FMS. The early-life risk markers identified by extensive literature review with best evidence for potential causal influence on the development and progression of CWP and FMS include genetic factors, premature birth, female sex, early childhood adversity, cognitive and psychosocial influences, impaired sleep, primary pain disorders, multiregional pain, physical trauma, infectious illness, obesity and inactivity, hypermobility of joints, iron deficiency, and small-fiber polyneuropathy. The case history illustrates the potential etiological influence of multiple risk markers offset by personal resilience.

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          Sex differences in pain and pain inhibition: multiple explanations of a controversial phenomenon.

          Jeffrey Mogil (2012)
          A clear majority of patients with chronic pain are women; however, it has been surprisingly difficult to determine whether this sex bias corresponds to actual sex differences in pain sensitivity. A survey of the currently available epidemiological and laboratory data indicates that the evidence for clinical and experimental sex differences in pain is overwhelming. Various explanations for this phenomenon have been given, ranging from experiential and sociocultural differences in pain experience between men and women to hormonally and genetically driven sex differences in brain neurochemistry.
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            Fibromyalgia.

            Winfried Häuser, Jacob Ablin, Mary-Ann Fitzcharles … (2015)
            Fibromyalgia is a common illness characterized by chronic widespread pain, sleep problems (including unrefreshing sleep), physical exhaustion and cognitive difficulties. The definition, pathogenesis and treatment are controversial, and some even contest the existence of this disorder. In 1990, the American College of Rheumatology (ACR) defined classification criteria that required multiple tender points (areas of tenderness occurring in muscles and muscle-tendon junctions) and chronic widespread pain. In 2010, the ACR preliminary diagnostic criteria excluded tender points, allowed less extensive pain and placed reliance on patient-reported somatic symptoms and cognitive difficulties. Fibromyalgia occurs in all populations worldwide, and symptom prevalence ranges between 2% and 4% in the general population. The prevalence of people who are actually diagnosed with fibromyalgia ('administrative prevalence') is much lower. A model of fibromyalgia pathogenesis has been suggested in which biological and psychosocial variables interact to influence the predisposition, triggering and aggravation of a chronic disease, but the details are unclear. Diagnosis requires the history of a typical cluster of symptoms and the exclusion of a somatic disease that sufficiently explains the symptoms by medical examination. Current evidence-based guidelines emphasize the value of multimodal treatments, which encompass both non-pharmacological and selected pharmacological treatments tailored to individual symptoms, including pain, fatigue, sleep problems and mood problems. For an illustrated summary of this Primer, visit: http://go.nature.com/LIBdDX.
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              Pain in children and adolescents: a common experience.

              Rene van der Heijden, Emile van Lin, John M A Bohnen … (2000)
              Little is known about the epidemiology of pain in children. We studied the prevalence of pain in Dutch children aged from 0 to 18 years in the open population, and the relationship with age, gender and pain parameters. A random sample of 1300 children aged 0-3 years was taken from the register of population in Rotterdam, The Netherlands. In the Rotterdam area, 27 primary schools and 14 secondary schools were selected to obtain a representative sample of 5336 children aged 4-18 years. Depending on the age of the child, a questionnaire was either mailed to the parents (0-3 years) or distributed at school (4-18 years). Of 6636 children surveyed, 5424 (82%) responded; response rates ranged from 64 to 92%, depending on the subject age and who completed the questionnaire. Of the respondents, 54% had experienced pain within the previous 3 months. Overall, a quarter of the respondents reported chronic pain (recurrent or continuous pain for more than 3 months). The prevalence of chronic pain increased with age, and was significantly higher for girls (P<0.001). In girls, a marked increase occurred in reporting chronic pain between 12 and 14 years of age. The most common types of pain in children were limb pain, headache and abdominal pain. Half of the respondents who had experienced pain reported to have multiple pain, and one-third of the chronic pain sufferers experienced frequent and intense pain. These multiple pains and severe pains were more often reported by girls (P<0.001). The intensity of pain was higher in the case of chronic pain (P<0. 001) and multiple pains (P<0.001), and for chronic pain the intensity was higher for girls (P<0.001). These findings indicate that chronic pain is a common complaint in childhood and adolescence. In particular, the high prevalence of severe chronic pain and multiple pain in girls aged 12 years and over calls for follow-up investigations documenting the various bio-psycho-social factors related to this pain.
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                Author and article information

                Contributors
                David Champion:
                ORCID: http://orcid.org/0000-0003-4557-262X
                Journal
                Journal ID (nlm-ta): Pain Res Manag
                Journal ID (iso-abbrev): Pain Res Manag
                Journal ID (publisher-id): PRM
                Title: Pain Research & Management
                Publisher: Hindawi
                ISSN (Print): 1203-6765
                ISSN (Electronic): 1918-1523
                Publication date Collection: 2019
                Publication date (Electronic): 5 May 2019
                Volume: 2019
                Electronic Location Identifier: 6584753
                Affiliations
                1Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
                2Department of Pain and Palliative Care, Sydney Children's Hospital, Sydney, New South Wales, Australia
                3School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
                Author notes

                Guest Editor: Emilia Matera

                Author information
                http://orcid.org/0000-0003-0354-4006
                http://orcid.org/0000-0003-4557-262X
                Article
                DOI: 10.1155/2019/6584753
                PMC ID: 6525804
                PubMed ID: 31191788
                SO-VID: 305a9d21-cbc6-4e0d-9c07-0d6e280ec052
                Copyright © Copyright © 2019 Aidan C. Tan et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 17 February 2019
                Date accepted : 12 March 2019
                Categories
                Subject: Review Article

                Data availability:

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