Fibromyalgia Syndrome has greater impact on patients

Three articles that were first published in late 2007 concluded that Fibromyalgia Syndrome (Fibro) has more of an impact on patients' lives and has more consequences for patients than many other chronic conditions and forms of widespread pain. [1] [2] [3]

The first article, on a study by reseachers Cöster et al at Linköping University, Sweden, was published in the European Journal of Pain. The study found that Fibro was associated with more severe symptoms/consequences for daily life and higher pain severity than chronic widespread pain without widespread allodynia. [1]

Allodynia is “Pain from stimuli which are not normally painful”, such as pain from a stroking motion on the skin.

The researchers said that Fibro is currently classified as chronic widespread pain with widespread allodynia to pressure pain, and that there have been few studies comparing Fibro with chronic widespread pain that does not have associated widespread allodynia. [1]

The study used a randomly selected sample from the general population, with a postal questionnaire and pain mannequin being sent to 9952 people. The response rate was 76.7% and the pain drawings showed that 345 people had widespread pain (in all four extremities and axially). Clinical examination, including a manual tender point examination, was performed in 125 subjects and these people answered commonly used questionnaires on pain, quality of life, coping strategies, depression, and anxiety. [1]

Chronic widespread pain without widespread allodynia to pressure pain was found in 4.5% in the population and Fibro was found in 2.5% of the population. [1]

The study found that, compared with chronic widespread pain without widespread allodynia, Fibro was associated with more severe symptoms/consequences for daily life and higher pain severity. Similar coping strategies were found in both groups. [1]

The second article, describing a study by Hoffman and Dukes in Connecticut, USA, was published in the International journal of clinical practice. [2]

They carried out a review of 37 studies of Fibro that measured health status with the 36-item Medical Outcomes Study Short-Form Health Survey (SF-36) or the 12-item Short-Form Health Survey (SF-12), describing how the health status profile of people with Fibro compares to that of people in the general population and patients with other health conditions. [2]

Hoffman and Dukes found that studies performed worldwide showed that people with Fibro were significantly more impaired than people in the general population in terms of all of the eight health factors assessed. [2]

These factors include:

1. Physical functioning
2. Role functioning difficulties caused by physical problems
3. Bodily pain
4. General health
5. Vitality (energy vs. fatigue)
6. Social functioning
7. Role functioning difficulties caused by emotional problems and mental health.

Groups of Fibro patients in the studies reviewed had both mental health and physical health scores below the general population and poorer overall health status compared to those with other specific pain conditions. Fibro patients had similar or significantly lower (poorer) physical and mental health status scores compared to those with rheumatoid arthritis, osteoarthritis, osteoporosis, systemic lupus erythematosus, myofacial pain syndrome, primary Sjögren’s syndrome and others. [2]

Hoffman and Dukes concluded that people with Fibro had an overall health status burden greater than that of people with other specific pain conditions that are widely accepted as impairing. [2]

The third article, from researchers Perruccio et al at the Toronto Western Research Institute, was published in the Journal of epidemiology and community health. [3]

Their study examined the relative impact of 13 chronic conditions using 3 outcome measures:

1. Activity limitations
2. Self-rated health
3. Physician visits

They found that, at the individual level, Fibro or Chronic Fatigue Syndrome and cancer (and to a lesser extent stroke and heart disease) were associated with an increased risk of both activity limitations and a self-rated health status of fair or poor (as opposed to good). [3]

These studies may be useful in demonstrating that Fibro can have a significant effect on a Fibro patient's life.

References:

1. Cöster L, Kendall S, Gerdle B, Henriksson C, Henriksson KG, Bengtsson A. Chronic widespread musculoskeletal pain - a comparison of those who meet criteria for fibromyalgia and those who do not. Eur J Pain. 2008 Jul;12(5):600-10. Epub 2007 Nov 19.
2. Hoffman DL, Dukes EM. The health status burden of people with fibromyalgia: a review of studies that assessed health status with the SF-36 or the SF-12. Int J Clin Pract. 2008 Jan;62(1):115-26. Epub 2007 Nov 24.
3. Perruccio AV, Power JD, Badley EM. The relative impact of 13 chronic conditions across three different outcomes. J Epidemiol Community Health. 2007 Dec;61(12):1056-61.