Affiliations: [a] Physical Medicine and Rehabilitation Department, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey | [b] Physical Medicine and Rehabilitation Clinic, Istanbul Research and Training Hospital, Ministry of Health, Istanbul, Turkey | [c] Physical Medicine and Rehabilitation Clinic, Vakif Gureba Research and Training Hospital, Ministry of Health, Istanbul, Turkey | [d] Physical Medicine and Rehabilitation Clinic, Medicine Hospital, Istanbul, Turkey | [e] Physical Medicine and Rehabilitation Clinic, Bagcilar Research and Training Hospital, Ministry of Health, Istanbul, Turkey
Abstract: Background:Cervical disc herniation (CDH) is the most common cause of cervical radiculopathy and could overlap with fibromyalgia (FM). Objective:The primary aim of the present study was to investigate the prevalences of FM and widespread pain in patients with cervical radiculopathy diagnosed as CDH in a cross-sectional study. The secondary aim was to analyze the localization of tender points (TPs) and associated symptoms in these patients comparing patients with FM. Methods:Fifty-two patients with cervical radiculopathy who carried the diagnosis of CDH and 51 patients with FM included to the study. The patients were questioned for the distribution and the duration of pain and for a group of symptoms related to FM such as headache, fatigue with a two-point scale (0 “no”, 1 “yes”). The diagnosis of CDH was made with patients’ clinical evaluation and radiological findings with Magnetic Resonans Imaging Study. FM was diagnosed using the American College of Rheumatology criteria. Widespread pain was defined as all of the following parameters were present: pain in the left side of the body; pain in the right side of the body; pain above the waist; pain below the waist; axial skeletal pain; and duration of pain for more than 3 months. The number of TPs were counted by digital palpation. Results:Six female patients (11.5%) with CDH fulfilled the ACR 1990 criteria for FM. Of the patients with CDH 71.8% of TPs were located around the neck and shoulder regions, while 58.7% of TPs of the patients with FM were located around these regions. There were statistically significant differences between the patients with CDH and the patients with FM in terms of the duration of widespread pain, the number of TPs and the localization of TPs (p< 0.05). Conclusions:The prevalences of FM and widespread pain in patients with CDH were found as 11.5% and 78.8% respectively.
