Trauma and psychological impact in fibromyalgia and other central sensitization syndromes: the role of anxiety and pain acceptance 2025 Maire et al

Andy

Andy

Senior Member (Voting rights)

Abstract​

Recent literature suggests an association between traumatic experiences and central sensitization syndromes (CSS), particularly fibromyalgia (FM). However, few studies have explored the specific variables involved in the relationship between post-traumatic stress disorder (PTSD) and the severity of central sensitization. This study aimed to compare the frequency and characteristics of trauma, PTSD, and clinical symptoms among FM patients, other CSS patients, and healthy controls, and to identify potential mediators between intensity of post-traumatic stress symptoms and central sensitization severity.

A cross-sectional study was conducted with 82 women with FM, 41 women with other CSS, and 43 healthy controls. The assessment protocol included a semi-structured interview, self-report measures of PTSD, central sensitization, pain and pain attitudes, sleep quality, fatigue, anxiety, depression, and disability; and objective measures to assess pressure pain thresholds via a digital algometry and sleep quality via actigraphy. Participants wore the actigraphs for one week. Statistical analyses included descriptive statistics, group comparisons using chi-square tests and one-way ANOVA with post-hoc tests, effect size estimations, correlation analyses, and a multiple mediation model.

FM patients reported higher trauma frequency and severity, and a higher prevalence of PTSD and intensity of post-traumatic stress symptoms than the CSS and healthy participants. The FM group also exhibited greater impairment across all clinical variables assessed, followed by the CSS group and healthy individuals. Within FM patients, those with PTSD showed more severe clinical profile than those without PTSD, highlighting the correlations between the intensity of post-traumatic stress symptoms and several clinical symptoms. In this subgroup of FM and PTSD, anxiety and pain acceptance are significant mediators in the relationship between post-traumatic stress symptoms and central sensitization.

The findings highlight the importance of assessing and addressing PTSD in patients with CSS, particularly FM. Individuals with FM/CSS may require a tailored treatment approach that emphasizes addressing emotions such as anxiety and increasing acceptance. Trauma resolution may have a relevant impact on FM/CSS and contribute substantially to improving the quality of life in this complex patient population.

Open access
 
"FM belongs to a group of syndromes that present high comorbidity among them and have been collectively called Central Sensitization Syndromes (CSS). CSS or nociplastic pain are an important group of conditions where medical test fails to detect abnormalities whose causality can be proven [4, 5]. CSS include fibromyalgia, chronic fatigue syndrome, multiple chemical sensitivity, irritable bowel syndrome, tension headaches and migraines, and most cases of temporomandibular, pelvic, and back chronic pain [4, 6]. These conditions share, in addition to pain, the presence of sleep disturbances, cognitive-affective alterations, and significant life stress, which has led to the suggestion that it is a common condition with different forms of clinical manifestation [4, 6]. One of the most relevant CSS in terms of its severity, chronicity and the functional limitations it implies is FM [4, 6]."
 
"The sample consisted of 82 women with FM (M = 53.20 years, SD = 8.54), 41 women with other CSS (M = 38.16 years, SD = 17.07), and 43 healthy controls (M = 40.71 years, SD = 14.07). Considering that FM and other CSS have a much higher prevalence in women than in men [2], only women were included in the present study. The inclusion criteria for FM and CSS groups were as follows: (a) being a women between 18 and 67 years old, (b) having adequate reading comprehension, (c) for the FM group: having a primary diagnosis of FM according to the criteria of the American College of Rheumatology [1], (d) for the CSS group: having a primary diagnosis of another CSS (excluding FM), specifically chronic fatigue syndrome, irritable bowel syndrome, chronic pelvic pain, temporomandibular joint disorder, and migraine/tension headache, according to the criteria of the International Classification of Diseases (ICD-10) [23], (e) having had the corresponding diagnosis for at least one year prior to the study, and (f) remain on a stable medication regimen for at least one month before the start of the study."
 
The concept of "pain acceptance" implies that you do your desired normal activities and learn mindfulness to assuage the noxious signals.

Sounds like a plan, except that high pain levels do not assuage with mindfulness.
Psychologists score: minus 1.
 
shak8 said:
The concept of "pain acceptance" implies that you do your desired normal activities and learn mindfulness to assuage the noxious signals.

Sounds like a plan, except that high pain levels do not assuage with mindfulness.
Psychologists score: minus 1.
Click to expand...
Sounds a lot like trying to convince the patients to complain less instead of actually trying to fix it.
 
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