Multiple-Site Pain in Fibromyalgia- A Confirmatory Factor Analysis

Fibromyalgia is a highly heterogeneous disorder occurring as widespread pain associated with general symptoms such as fatigue, depression, anxiety, insomnia, sexual dysfunction, and gastrointestinal conditions. This cross-sectional single tertiary medical center survey study aimed to investigate how multiple pain sites contribute to the construct of general pain in fibromyalgia. Altogether 266 women with fibromyalgia aged 18 to 60 years were included in the analysis. Confirmatory factor analysis of pain severity measured by a visual analogue scale (0 to 100 points) in seven major body regions. Headache, low back pain, and neck pain explained most of the total variance in general pain perceived across seven different body regions. Substantial correlations of 0.71, 0.68, and 0.61 were found between general pain and headache, low back pain, and neck pain, respectively. Pain reported for other four regions (chest, abdomen, upper extremity, and lower extremity) demonstrated fair correlations with general pain. When experiencing multi-site pain, women with fibromyalgia perceived headache, low back pain, and neck pain being subjectively more important than pain in other sites. While pain intensity and location commonly varies in fibromyalgia patients, it is important that one is aware of most common sites to be able to recognize fibromyalgia so that it can be managed properly.