Quantitative sensory testing of pressure pain thresholds in adolescents with Juvenile Fibromyalgia

Fibromyalgia (FM) is characterized by widespread pain and heightened pain sensitivity related to alterations in pain processing in the central nervous system, as well as increased levels of anxiety and depressive symptoms. Quantitative Sensory Testing (QST), primarily mechanical/pressure pain paradigms, have been used to assess pain sensitivity in adults with FM but no norms currently exist for adolescents with juvenile fibromyalgia (JFM). This study aimed to compare pressure pain thresholds of adolescents with JFM to matched healthy controls (HC), controlling for the potential effects of anxiety on pain sensitivity. Adolescent females (ages 12-18) with JFM (N=19) and HC (N=21) underwent a standardized QST protocol with digital algometry (Medoc AlgoMed™) pressure applied bilaterally to the thenar eminence of the palm and forehead to a maximal pressure of 4 kg/cm2. Order effects were controlled by counterbalancing the order of testing site (palm/forehead). Before QST, participants provided an average pain rating on an 11-point Numeric Pain Rating Scale (NRS; 0 = no pain; 10 = pain as bad as it can be) and completed the State-Trait Anxiety Inventory. Independent sample t-tests revealed that JFM patients had significantly lower pain thresholds (Forehead MJFM=1.13 kg/cm2; MHC =1.72 kg/cm2 and Palm MJFM=1.70 kg/cm2; MHC=2.35 kg/cm2), higher pain NRS scores (MJFM=5.63, MHC=2.33) and Trait anxiety (MJFM=45.21; MHC=33.33) compared to HC (all p’s