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Visceral pain assessment should be considered as a part of FMS management as visceral pain significantly enhanced fibromyalgia pain and hyperalgesia in co-morbid patients.
The treatment of visceral pain should be a part of the management of FMS. In a recent study it was found that the visceral pain increased FMS symptoms and central sensitization. A central sensitization syndrome characterized by peripheral pain and hyperalgesia is fibromyalgia syndrome (FMS). The symptoms include allodynia and musculoskeletal pain. The visceral pain may be the triggering factor for FMS and hyperalgesia in comorbid patients, so a prospective study was conducted for its evaluation. A comparison of the comorbid groups i.e. women with FMS and irritable bowel syndrome (IBS); FMS and colon diverticulosis (Div); FMS and primary dysmenorrhea (Dys); FMS and Dys secondary to endometriosis (Endo) was done to the women with FMS only for fibromyalgia over comparable periods, for somatic hyperalgesia in tender joints and control areas like trapezius, deltoid, quadriceps, overlying subcutis, and skin. FMS symptoms were also re-assessed in comorbid subgroups after treatment of the visceral conditions or with no treatment. Researchers observed that the FMS pain was significantly higher in all the comorbid groups (0.05 < P < 0.0001). Visceral pain, i.e., Number of IBS days, painful menstrual cycles, abdominal pain from Div was observed to be directly associated with FMS pain and in inversely with muscle pain threshold at all sites (0.03 < P < 0.0001).
In the patients receiving six months of dietary, hormonal treatment for visceral comorbidity the FMS pain and hyperalgesia got decreased significantly (0.05 < P < 0.0001).
Pain, North Carolina
Visceral pain as a triggering factor for fibromyalgia symptoms in comorbid patients
Raffaele Costantini et. al.
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