Open Access Highly Accessed Research article

Fibromyalgia and neuropathic pain - differences and similarities. A comparison of 3057 patients with diabetic painful neuropathy and fibromyalgia

Jana Koroschetz1, Stefanie E Rehm1, Ulrich Gockel2, Mathias Brosz3, Rainer Freynhagen4, Thomas R Tölle5 and Ralf Baron1*

Author affiliations

1 Sektion Neurologische Schmerzforschung und -therapie, Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold Heller- Str. 3, Haus 41, 24105 Kiel, Germany

2 CASQUAR GmbH Computerassoziierte Qualitätssicherung u. Rehabilitations-förderung, Akademiestr. 42, 44789 Bochum, Germany

3 StatConsult GmbH, Halberstaedter Str. 40a, 39112 Magdeburg, Germany

4 Zentrum für Anästhesiologie, Intensivmedizin, Schmerztherapie und Palliativmedizin, Benedictus Krankenhaus Tutzing, Bahnhofstraße 5, 82327 Tutzing, Germany

5 Klinik für Neurologie, Technische Universität München, 81675 München, Germany

For all author emails, please log on.

Citation and License

BMC Neurology 2011, 11:55  doi:10.1186/1471-2377-11-55

Published: 25 May 2011

Abstract

Background

Patients with diabetic neuropathy (DPN) and fibromyalgia differ substantially in pathogenetic factors and the spatial distribution of the perceived pain. We questioned whether, despite these obvious differences, similar abnormal sensory complaints and pain qualities exist in both entities. We hypothesized that similar sensory symptoms might be associated with similar mechanisms of pain generation. The aims were (1) to compare epidemiological features and co-morbidities and (2) to identify similarities and differences of sensory symptoms in both entities.

Methods

The present multi-center study compares epidemiological data and sensory symptoms of a large cohort of 1434 fibromyalgia patients and 1623 patients with painful diabetic neuropathy. Data acquisition included standard demographic questions and self-report questionnaires (MOS sleep scale, PHQ-9, PainDETECT). To identify subgroups of patients with characteristic combinations of symptoms (sensory profiles) a cluster analysis was performed using all patients in both cohorts.

Results

Significant differences in co-morbidities (depression, sleep disturbance) were found between both disorders. Patients of both aetiologies chose very similar descriptors to characterize their sensory perceptions. Burning pain, prickling and touch-evoked allodynia were present in the same frequency. Five subgroups with distinct symptom profiles could be detected. Two of the subgroups were characteristic for fibromyalgia whereas one profile occurred predominantly in DPN patients. Two profiles were found frequently in patients of both entities (20-35%).

Conclusions

DPN and fibromyalgia patients experience very similar sensory phenomena. The combination of sensory symptoms - the sensory profile - is in most cases distinct and almost unique for each one of the two entities indicating aetiology-specific mechanisms of symptom generation. Beside the unique aetiology-specific sensory profiles an overlap of sensory profiles can be found in 20-35% of patients of both aetiologies.