Two faces of chronic pain: distinct psychosocial profiles in headache and fibromyalgia

Clin Exp Rheumatol. 2026 Mar 10. doi: 10.55563/clinexprheumatol/d586el. Online ahead of print.

ABSTRACT

OBJECTIVES: Chronic pain significantly impacts quality of life. Headache and fibromyalgia are common chronic pain disorders, often linked to cognitive, emotional, and social impairments. This study examined the associations between pain, related symptoms, and psychosocial outcomes in individuals with chronic headache and fibromyalgia.

METHODS: A cross-sectional online study was conducted on 42 participants: 21 with chronic headache and 21 with fibromyalgia. Data were collected on pain intensity and interference (Numeric Rating Scale, Brief Pain Inventory) and psychosocial variables (Pain Self-Efficacy Questionnaire, Pain Catastrophising Scale, 12-Item Short Form Survey).

RESULTS: Headache participants reported moderate pain intensity (mean NRS=5.5, SD=2.3), with BPI intensity significantly correlated with general activity (r=.621, p=.003), mood (r=.730, p=.001), and self-efficacy (r=.515, p=.017). Specific symptoms such as motor (rs=.682, p=.001) and sensory deficits (rs=.541, p=.011) were strongly associated with PCS rumination. In the fibromyalgia group, pain intensity was higher (mean NRS=7.38, SD=2.2) and correlated with PCS total (r = .606, p = .004), helplessness (r=.777, p<.001), and interference with daily life (r=.823, p<.001). Mental health (SF-12 MCS) was negatively associated with pain in fibromyalgia but not in headache.

CONCLUSIONS: While both conditions are linked to psychosocial impairment, fibromyalgia was associated with higher pain intensity and stronger correlations with psychological dysfunction, while chronic headache showed more selective associations, particularly involving perceived interference with mood and ruminative thinking.

PMID:41810853 | DOI:10.55563/clinexprheumatol/d586el