Cited by 634Fibromyalgia and Chronic Fatigue Syndrome ResearchPain Mechanisms and TreatmentsPain Management and Treatment

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Widespread pain in fibromyalgia is related to a deficit of endogenous pain inhibition

Julien, Nancy, Goffaux, Philippe, Arsenault, Pierre, Marchand, Serge·2005·Pain

DOI 10.1016/j.pain.2004.12.032

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Abstract

A deficit of endogenous pain inhibitory systems has been suggested to contribute to some chronic pain conditions, one of them being fibromyalgia. The aim of the investigation was to test whether endogenous pain inhibitory systems were activated by a spatial summation procedure in 30 fibromyalgia, 30 chronic low back pain, and 30 healthy volunteers who participated in a cross-over trial (two sessions). Each session consisted of visual analog scale ratings of pain during the immersion of different surfaces of the arm in circulating noxious cold (12 degrees C) water. The arm was arbitrarily divided into eight segments from the fingertips to the shoulder. One session was ascending (from the fingertips to the shoulder) and the other was descending (from the shoulder to the fingertips); they included eight consecutive 2-min immersions separated by 5-min resting periods. For healthy and low back pain subjects, pain was perceived differently during the ascending and descending sessions (P=0.0001). The descending session resulted in lower pain intensity and unpleasantness. This lowering of the perception curve seems to be due to a full recruitment of inhibitory systems at the beginning of the descending session as opposed to a gradual recruitment during the ascending session. For fibromyalgia subjects, no significant differences were found between the increasing and decreasing sessions (P>0.05). These data support a deficit of endogenous pain inhibitory systems in fibromyalgia but not in chronic low back pain. The treatments proposed to fibromyalgia patients should aim at stimulating the activity of those endogenous systems.

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Authors: Julien, N., Goffaux, P., Arsenault, P., & Marchand, S.
Affiliations: Université du Québec en Abitibi-Témiscamingue (CA)
Université de Sherbrooke (CA)
Corresponding author: Marchand, Serge
ORCID: Julien, Nancy
Marchand, Serge
Venue: Pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2005-03
Volume: 114
Issue: 1
Pages: 295-302
ISSN: 0304-3959 (ISSN-L)
DOI: 10.1016/j.pain.2004.12.032
OpenAlex: W2059810347
Cited by: 634
References: 30
Citations by year: 2026: 7 · 2025: 23 · 2024: 15 · 2023: 19 · 2022: 22 · 2021: 31 · 2020: 32 · 2019: 20 · 2018: 35 · 2017: 26 · 2016: 32 · 2015: 44 · 2014: 36 · 2013: 49 · 2012: 40
FWCI: 16.53
Type: journal article
Language: en
Open access: closed
Locations: Pain (publishedVersion)
PubMed (publishedVersion)
Funders: Canadian Institutes of Health Research
Natural Sciences and Engineering Research Council of Canada
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords: fibromyalgia, widespread pain, endogenous pain inhibition, descending pain inhibition, spatial summation, cold pressor pain, chronic low back pain, descending pain modulation, pain unpleasantness
MeSH terms: Adult, Cold Temperature, Female, Fibromyalgia, Humans, Male, Middle Aged, Neural Inhibition, Pain, Pain Measurement, Regression Analysis, Cross-Over Studies

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Widespread pain in fibromyalgia is related to a deficit of endogenous pain inhibition

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