Differences between patients with fibromyalgia and chronic low back pain in balance and sensitivity to pain

Abstract

[eng] Fibromyalgia and chronic low back pain are two chronic diseases with several similarities from a clinical point of view. Thus, for instance, both are highfrequent reasons for medical consultation in primary care and both seriously affect patient’s quality of life due to the numerous symptoms. Moreover, it has been observed that patients with fibromyalgia and chronic low back pain showed similar patterns in terms of the pain response. The objective of the present study was to analyse if patients with fibromyalgia and patients with chronic low back pain (CLBP) displayed a similar impairment of physical function or not. For this purpose, measurements of pain sensitivity, postural balance, muscle strength, fatigue and impact of pain on daily life was obtained by using objective standardized instruments and self-report questionnaires. Overall, we found that patients with fibromyalgia displayed worse performance in several motor tasks and reported greater impact of pain on daily life than patients with CLBP. Moreover, higher pain sensitivity at several body locations patients, together with reduced sensitivity to vibration stimuli were observed in patients with fibromyalgia in comparison with patients with CLBP. The present study suggests that in addition to the role of central sensitization for the maintenance of persistent pain, widespread brain changes could be also responsible for altered physical functioning and impaired quality of life in fibromyalgia in comparison with patients with chronic low back pain. This would imply that intervention techniques for pain relief should also include strategies for improving physical functioning in fibromyalgia.