Identification of subgroups in experimental and chronic pain : Sensory, emotional and evaluative aspects

Abstract: One hundred and two healthy subjects, 32 fibromyalgia patients and 12 chronic low back pain patients were included in the study. Quantitative sensory tests were performed to identify thermal hyperalgesia in the fibromyalgia group and to compare the results with those in healthy pain-free subjects. Different questionnaires were used to map pain and stress-coping strategies /styles. (Coping Strategy Questionnaire, Jalowiec Coping Scale) and quality of life (Life Satisfaction Questionnaire and the SF-36).Both healthy subjects and fibromyalgia patients suffering from chronic pain could be subgrouped according to experimental pain perception. On comparing the fibromyalgia subgroups, differences in both stress and pain-coping strategies were found. Thus, the confrontative stress-coping style was used more in the thermal painsensitive group than the others. Furthermore, attention-diverting and catastrophising pain-coping strategies were more frequent.The chronic back-pain patients who had decreased their catastrophising pain-coping strategy at the 3-year follow-up also perceived an improved quality of life at the 6-year follow-up.When. self-scoring life satisfaction, thermal pain-sensitive fibromyalgia patients experienced significantly more physical symptoms than slightly cold pain-sensitive patients and healthy subjects. They also had sleep disturbances, more tender points, more affective hand pain and increased hand pain intensity.The relation between sensation and emotion must be regarded as a product of a conscious mind while the emotional part of the pain sensation is not just a passive response to an external stimulus.