Coping strategies in fibromyalgia, chronic neuropathic pain, and pain-free controls
Neuropathic pain is caused by a metabolic damage of primary afferent neurons. The sensory symptoms include numbness, prickling, burning or electric shocks. Whereas, fibromyalgia (FM) is a chronic pain condition characterized by widespread pain, mainly perceived in deep somatic tissues (muscle and joints). Patients may also have abnormal pain sensitivity and frequent additional comorbidities like sleep disturbances and effective disorders.
Patients with diabetic neuropathy (DPN) and fibromyalgia differ substantially in pathogenic factors and spatial distribution of the perceived pain. Similar abnormal sensory complaints and pain exists in both conditions. Patients with chronic pain can experience benefits through learning adaptive coping strategies. Consensus on efficient strategies for this group of patients is however lacking and previous studies have shown inconsistent results. A study has examined the coping strategies in two distinctly different groups of chronic pain patients with a group of healthy controls.
In trial, 30 neuropathic pain patients, 28 fibromyalgia patients and 26 pain free healthy controls completed the Coping Strategy Questionnaire (CSQ-48/27) and rated their daily pain. After trial, results which were observed showed that FM and NP patients did not cope differently with pain. The only difference was that FM patients felt more in control of their pain than NP patients. Both patient groups used more maladaptive/passive coping strategies but surprisingly also more adaptive/active coping strategies than healthy controls.
However, patients with high levels of passive strategies felt less in control than patients with low levels of passive strategies. This was not seen in patients with neuropathic pain. An important implication is therefore, that passive coping strategies should be restructured into active ones, especially for FM patients. Otherwise, the same psychological treatment model can be applied to both groups since they use similar coping styles.