Risk Factors for Developing Fibromyalgia

Palm Springs—Fibromyalgia, a chronic condition characterized by chronic widespread pain, hyperalgesia, allodynia, and chronic fatigue, affects 3 million to 5 million people in the United States. Previous studies have linked fibromyalgia to infection, trauma, metabolic derangements, and genetic disposition; however, no clear causality has been established. To aid in further understanding this condition, researchers recently conducted a study aimed at identifying risk factors for developing fibromyalgia. They presented study results at the AAPM meeting in a poster titled Quantifying Risk Factors and Quality of Life Measures in Fibromyalgia Using the Behavioral and Risk Factor Surveillance System. The study was conducted in the greater New York City area with patients diagnosed with fibromyalgia for at least 30 days based on clinical presentation according to the American College of Rheumatology 1990 Criteria for Classification of Fibromyalgia. The researchers conducted 36 interviews (31 females, 5 males) between August and December 2010; the interviews were conducted an average of 11.4 years after the diagnosis of fibromyalgia. All study subjects received the Behavioral Risk Factor Surveillance System (BRFSS) survey. The study participants were asked to rate their overall health; 15 said their health was good (or better) and 21 described their health as fair (or worse). Only 5 self-identified as disabled in some way. When asked about receiving social and emotional help, 18 said they usually received the support they needed. In response to questions about their lives in general, 17 said they were satisfied (or better) with their life. All of these responses were statistically significant, corresponding to a P value <.001 for the less desirable outcome in all categories. One of the BRFSS sections pertains to “adverse childhood experiences.” In this section of the interview, patients were asked to respond to a set of 11 questions pertaining to their lives between the ages of 0 and 18 years, to the best of their memory. The questions included whether they lived with anyone who was depressed, mentally ill, or suicidal; an alcoholic or drug addict; or anyone who was sentenced to serve time in a correctional facility. Questions also included status of the participant’s parents (whether they were separated or divorced) as well as sensitive areas such as possible sexual abuse suffered by the participant at the hand of a parent or caregiver. The responses to the adverse childhood experiences section of the survey revealed several trends. There was a statistically significant association with growing up with a depressed parent, being hit by a parent, being insulted or sworn at by a parent, and having been sexually abused (P<.001 for the undesirable answer). When asked about pain level in the previous 30 days, patients reported an average of 21.6 days where pain made it difficult to perform usual activities. Patients also reported averages of 15.3 days of feeling depressed, 18.8 days of feeling worried, 4.96 days of feeling full of energy, and 20.2 days of not getting enough sleep or rest, despite some of the patients being medicated for sleep problems. The patients reported an average of 7.51 hours of sleep over a 24-hour period. The researchers commented that the responses in the adverse childhood experiences section were “the most interesting data and helped clarify the belief that traumatic childhood experience contributes to fibromyalgia syndrome.” They continued by noting that the study demonstrated a “concrete, very statistically significant link between types of traumatic childhood experiences and developing fibromyalgia” and it “helped implicate what specific childhood events increase one’s risk for fibromyalgia. Finally, the researchers added that the BRFSS survey should be used in further studies for evaluating risk factors. “While these results are promising, and help sharpen the focus for risk factors related to fibromyalgia, more data are needed,” they concluded.