The objective of the study was to investigate the relationship between spontaneous and provoked pain in fibromyalgia and to evaluate the frequency of disturbances associated with muscle pain, including some disturbances which are not usually considered as typical symptoms associated with pain in fibromyalgia.
In sixty-seven patients with fibromyalgia the severity of spontaneous pain was assessed by a visual analogue scale and the severity of provoked pain by an original method, which includes the evaluation of the number of tender points and the evaluation of the intensity of provoked pain. The method used to assess the severity of provoked pain is more sensitive than other methods currently used. The occurrence of accompanying symptoms was also evaluated. The investigation included the occurrence of paresthesias of the upper limbs, hemorrhoids and epistaxis, which are not usually considered as typical symptoms associated with fibromyalgia.
No significant correlation was observed between the severity of spontaneous and provoked pain. The following disturbances were more frequent in the examined patients than in general population: headache, chronic fatigue, sleep disorders, irritable bowel syndrome, restless legs syndrome, paresthesias in the upper limbs, hemorrhoids and epistaxis.
Spontaneous and provoked pain should be considered two independent clinical features of fibromyalgia. Paresthesias in the upper limbs, hemorrhoids and epistaxis should be considered as typical symptoms associated with fibromyalgia. Hemorrhoids and epistaxis are frequently due to a diathesis characterized by laxity of connective tissues and fibromyalgia could be a consequence of such a diathesis.