When you go to the doctor, do you cringe when the nurse pulls out the cuff to take your blood pressure -- because you know it’s going to be painful? I know I do – and I always feel like a wimp because I can’t even tolerate a simple blood pressure test. One nurse actually called me a wimp, but another more kind-hearted nurse taught me to ask for the large cuff, which does significantly reduce the degree of pain I experience.
Apparently, I’m not alone. In a recent study, 69 percent of fibromyalgia patients experienced pain from blood pressure testing. The study entitled, “Sphygmomanometry-Evoked Allodynia – A Simple Bedside Test Indicative of Fibromyalgia: A Multicenter Developmental Study,” was published in the December 2006 issue of the Journal of Clinical Rheumatology.
Terminology: Sphygmomanometry is the long word for the simple and standard blood pressure test which everyone receives at the doctor's office. Allodynia is a condition in which pain results from a stimulus that does not normally evoke pain.
Objective: The objective of the study was to determine whether a universally used clinical test -- sphygmomanometry -- would be helpful in identifying FM patients.
Method: Researchers studied 20 fibromyalgia patients, 20 rheumatoid arthritis (RA) patients, 20 osteoarthritis (OA) patients and 20 healthy individuals in each of three public rheumatology outpatient services. Each participant was asked to answer the question, “When I take your blood pressure, tell me if the cuff’s pressure brings forth pain.”
Results: While 69 percent of FM patients experienced sphygmomanometry-evoked allodynia, only 10 percent of OA patients, five percent of RA patients and two percent of healthy individuals did. The mean blood pressure value at which FM patients felt pain was lower than the other three groups. FM patients showed a negative correlation between the blood pressure value at which the allodynia developed and the total Fibromyalgia Impact Questionnaire (FIQ) score, number of tender points, and the FIQ visual analog scales for pain intensity and fatigue.
Conclusions: In this study, there was a strong association between pain experienced during blood pressure testing and the diagnosis of FM. Sphygmomanometry is a simple test and a universally standard clinical procedure that may be useful in recognizing FM patients. Based on the results of this study, the researchers suggest looking for other FM features in anyone who has sphygmomanometry-evoked allodynia.
Source: Vargas, Alfonso MD, et al. Sphygmomanometry-Evoked Allodynia – A Simple Bedside Test Indicative of Fibromyalgia: A Multicenter Developmental Study Journal of Clinical Rheumatology. 2006 Dec;12(6):272-4.
