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Papers: 7 May 2022 - 13 May 2022

2022 May 10


Generalized sensory sensitivity is associated with comorbid pain symptoms: a replication study in women with dysmenorrhea.



Dysmenorrhea is characterized by high rates of transition to chronic pain. In a previous study using structural equation modeling we demonstrated that several symptom domains associated with the emerging concept of nociplastic pain can be described using two symptom groups: generalized sensory sensitivity (GSS; composed of widespread pain, interceptive sensitivity, and environmental sensitivity) and SPACE (composed of unrefreshing Sleep, Pain, Affective disturbances, Cognitive issues, and reduced Energy). Here we perform a secondary cross-sectional analysis examining the same symptoms groups in a cohort of dysmenorrhea patients without a diagnosis of chronic pain. Our purpose is to determine if the same symptom patterns are apparent, and if they are associated with the presence and severity of comorbid pain. Participants were 201 women with dysmenorrhea. We replicated the hypothesized two-factor structure in this cohort (comparative fit index = .971, root mean square error of approximation =.055; 90% CI: .000, .097). GSS was associated with the severity of bladder, bowel, and overall pain in multivariable models including SPACE, patient age, and BMI (all β > .32, all p < .05). SPACE was associated with menstrual pain during NSAID use, while GSS was associated with the same in the absence of NSAID use (both p < .05). This two-factor model of symptoms appears to be replicable and valid in a cohort of women at risk for developing chronic pain conditions. These symptom groups are promising potential markers of future pain chronification and may point to patients in need of earlier or more aggressive intervention.