Differential Sensory and Clinical Phenotypes of Patients With Chronic Widespread and Regional Musculoskeletal Pain

Marina M. Finnern; Dieter Kleinböhl; Herta Flor; Justus Benrath; Rupert Hölzl


Pain. 2020;162(1):56-70. 

In This Article


This cross-sectional study has several limitations: We included nonrandom clinic attendant samples that may not be representative of the chronic pain population in general. Moreover, we used multiple sequential structure-finding methods in which the indicator sets for the final phenotyping were optimized to retain maximum case numbers. The statistical probabilities of this explorative definition phase are inflated, but the final profile clustering is not, nor are the comparisons between clusters with respect to diagnoses, comorbidity, or psychosocial factors, which were corrected for α-inflation. The combined explorative-inferential strategy may also have lost relevant phenotypes marked by indicators that were abandoned because of sample attrition, sex prevalence differences, or unreliability of sensory assessments. The positively identified phenotypes, however, should be valid and so should the core result on the phenotypical heterogeneity of fibromyalgia and regional pain categories and the necessity to reinstall sufficient sensory assessment.