Women with fibromyalgia often have less self-esteem and a distorted perception of their own bodies. This may impair their capacity to process sensory stimuli and contribute to the sensation of chronic pain, according to researchers from Spain.
This finding was reported in a small study titled, “Embodied pain in fibromyalgia: Disturbed somatorepresentations and increased plasticity of the body schema,” published in the journal Plos One.
The sensation of pain is controlled by different elements. Cognitive factors such as attention, anticipation, emotion, and memory of previous pain can affect the way a person perceives pain.
Body image and body perception can also contribute to feelings of exacerbated or diminished pain sensitivity. Increasing evidence has suggested an association between a patient’s chronic pain and a distorted image of their body.
To better understand whether body awareness is associated with pain sensation, researchers from the University of the Basque Country in northern Spain evaluated 14 women with fibromyalgia and 13 healthy volunteers.
Several fundamental aspects of body awareness were analyzed, including plasticity of the body response and movement, body image, and awareness of normal body activity.
Women with fibromyalgia were found to have lower self-esteem than their healthy counterparts, reporting less satisfaction with their bodies. The patients had lower scores for all items when measured by the Body Esteem Scale (BES). Regions of the body with lower scores were found to be those where patients felt the most pain.
Results of the Body Perception Questionnaire (BPQ) revealed that fibromyalgia patients had significantly higher scores for body awareness, stress response, autonomic nervous system reactivity, and stress style. The intensity of ongoing pain was found to be strongly correlated with patients’ interoceptive awareness — the ability to perceive the body’s normal functions.
The researchers believe these results “suggest a disturbed embodiment in fibromyalgia, characterized by instability of the body schema, negatively biased cognitions regarding one’s own body, and increased vigilance to internal bodily cues.”
It is not clear if altered body awareness and perceptions are a cause or a consequence of fibromyalgia.
Still, they can be interpreted as a response to the “inability to adequately” read incoming sensory inputs and “update the biased off-line representations” of the body and pain “stored as long-term memory,” the researchers wrote.