Fibromyalgia, a chronic pain illness, affects up to six million Americans, primarily women of childbearing age, according to the American College of Rheumatology.

Some experts believe that fibromyalgia patients who are also prone to emotional problems, such as depression and anxiety, are more likely to experience greater physical pain in areas called "tender points."

Common tender points are the front of the knees, the elbows, the hip joints, the neck and the spine. Some physicians also think that patients with emotional issues have more sleep disturbances, morning stiffness, irritable bowel syndrome and anxiety than patients with a more positive outlook.

But a recent study may change their ideas.


Dr. Thorsten Giesecke, a former research fellow at the University of Michigan, and his colleagues evaluated 85 female and 12 male fibromyalgia patients. The patients answered a series of questions about their coping strategies and personality traits—particularly about their emotional well-being. They also were tested for sensitivity to pressure and pain.

The patients fell into three subgroups that refuted conventional wisdom.

The first subgroup consisted of 50 patients who had moderate levels of anxiety and depression. They also felt that they had moderate control over their pain, and they experienced low to moderate levels of pain.

The second group included 31 patients with high levels of anxiety and depression. They felt that they had the least control over their pain, and they had high levels of tenderness. The third group, with 16 patients, reported the lowest levels of anxiety and depression and the highest control over their pain. Yet the testing showed that they experienced the highest levels of physical pain.

Some patients have extreme pain but no psychological problems, Giesecke explains, while others have moderate pain and faidy positive moods.


The findings may help tailor treatments to specific individuals. For example, antidepressants might not work well on group three, whose members were not depressed. They might benefit from exercise therapy instead, Giesecke says.

"It's easy to say it's all in their head," says Bruce Nalibofl, a clinical professor at the UCLA David Geffen School of Medicine. The study will help prove that's not so, he adds.

To learn about the symptoms of fibromyalgia and how to manage this condition, visit

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