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

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11

 

  1. Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy.
  2. Department of Oncology and Haemato-Oncology, University of Milan, Italy.
  3. Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy.
  4. Department of Oncology and Haemato-Oncology, University of Milan, Milan, Italy.
  5. Department of Oncology and Haemato-Oncology, University of Milan, Milan, Italy.
  6. Department of Oncology and Haemato-Oncology, University of Milan; and Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy.
  7. Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy.
  8. Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy.
  9. Department of Oncology and Haemato-Oncology, University of Milan; and Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology, Milan, Italy.
  10. Aldo Ravelli Centre for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan; and Clinical Neurology Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, Milan, Italy.
  11. Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan; and Department of Oncology and Haemato-Oncology, University of Milan, Italy. roberta.ferrucci@unimi.it

CER19179
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PMID: 41810853 [PubMed]

Received: 02/08/2025
Accepted : 03/11/2025
In Press: 10/03/2026

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.

DOI: https://doi.org/10.55563/clinexprheumatol/d586el

Rheumatology Article