SUMMARY Neither physicians nor psychologists have valid tools for assessing disability caused by chronic widespread pain. For most FMS patients there are significant discrepancies between self-report and observed functioning.
Neither physicians nor psychologists have valid tools for assessing disability caused by chronic widespread pain. There are no reliable clinical tests of disability attributed to pain 1.
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PRACTICE POINT Clinical assessments of disability caused by chronic widespread pain are little more than judgments of credibility |
Once significant or relevant physical disease and major psychiatric disorder has been excluded by careful medical and psychological assessment, further physical and mental examination is unhelpful in determining Disability 2.
For most FMS patients there are significant discrepancies between self-report and observed functioning. A promising approach 3 has been to categorise FMS patients on psychosocial and behavioural responses to pain as Dysfunctional, Interpersonally Distressed, or Adaptive Copers for purposes of research into effective therapies. In this study, only the Adaptive Copers showed a relationship between perceived disability and physical functioning, as measured by spinal mobility tests. Although the other two groups showed comparable levels of physical functioning, they reported more pain and greater disability.
In contrast to patients suffering from other rheumatic conditions (ankylosing spondylitis and rheumatoid arthritis), FMS patients showed "striking discordance" between self-report and overt clinical surveillance 4.
Similarly, FMS patients report more pain than do patients with severe rheumatoid arthritis and other rheumatic disorders 5.
Does Trauma
Cause Chronic Widespread Pain?
Does Chronic Widespread Pain Cause Disability?
Should Disability Attributed to Chronic Widespread
Pain be Financially Compensated?
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