Background/Purpose: Chronic widespread pain is common in the general population with a prevalence ranging between 4.2% and 13.3%. It has been identified as a major health problem. The aim of this study was to evaluate the prognostic value of tender point count, pressure pain thresholds and pain group classification with regard to chronic widespread pain report and self-reported SF-36 quality of life measurements in persons with a history of chronic widespread pain.

Methods: A cohort of 303 individuals was identified as having self-reported chronic widespread pain in a cross-sectional survey with 3928 participants. 146 of the 303 individuals underwent clinical examination with palpation of tender points, dolorimeter pressure pain threshold examination and pain grouping (no chronic pain, chronic regional pain, and chronic widespread pain) based on a report of painful regions on a drawing of the body with predefined regions. Chronic widespread pain was evaluated according to the American College of Rheumatology 1990 criteria for fibromyalgia. Two and seven years later, pain classification and SF-36 quality of life assessments were collected from postal questionnaires. Sex and age adjusted OR were calculated for each clinical baseline factor separately.

Results: Having more than four tender points significantly (p<0.05) predicted a four time higher risk of reporting chronic widespread pain at the two (OR=4.33) and seven (OR=3.89) year follow up. Having 11- 18 tender points at baseline was superior to a report of chronic widespread pain in predicting a low SF-36 vitality score. Chronic widespread pain at baseline strongly predicted chronic widespread pain two and seven years later. Low pressure pain thresholds did predict chronic widespread pain and a low health status although the associations were subordinated the prognostic value of tender point counts and widespread pain classification.

Conclusion: Easy attainable anamnestic and clinical findings such as a report of chronic widespread pain and a tender point count above four can be used as prognostic signs in the clinical evaluation of patients with a history of longstanding pain.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/tender-point-count-and-pressure-pain-threshold-as-predictors-of-chronic-widespread-pain-and-health-status-in-a-seven-year-prospective-study/