Hyperalgesia in Fibromyalgia

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A study was done by Berglund et al. of twenty females with fibromyalgia and 20 healthy age-matched controls looking at somatosensory perception thresholds, perceived intensity, and the quality of perceptions in response to thermal (Thermotest) stimuli and stimulation by von Frey filaments which are essentially small pointed filaments that are poked against the skin. Results of the thermal testing found: “Perception thresholds for cold pain, heat pain, cold-pain tolerance and heat-pain tolerance were significantly lower in patients than controls.” (Quantitative and qualitative perceptual analysis of cold dysesthesia and hyperalgesia in fibromyalgia. Berglund B1, Harju EL, Kosek E, Lindblom U. Pain. 2002 Mar;96(1-2):177-87.)

Their most striking finding “was the aberration of cold-evoked perceptions in all patients: most stimuli in the range of 30-10 degrees C were reported as heat or other paresthetic or dysesthetic perceptions.”

In addition, they found that in the patients “the nociceptive range of thermal and of tactile stimulation” had “significantly more frequent pain-related descriptors than in controls.”

In summary the fibromyalgia group had a “combination of cold hyperesthesia, cold dysesthesia, and multimodal hyperalgesia”. The authors pondered which brain areas might be involved in this. They speculated that the insular cortex might be involved.