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Benebo FO, Lukic M, Jakobsen MD, Braaten TB. Lifestyle risk factors of self-reported fibromyalgia in the Norwegian Women and Cancer (NOWAC) study. BMC Public Health 2023; 23:1967. [PMID: 37821848 PMCID: PMC10566054 DOI: 10.1186/s12889-023-16773-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 09/16/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND While the aetiology of fibromyalgia syndrome (FM) remains unknown, lifestyle factors have been linked to the disorder. However, there are few studies on the association between lifestyle factors and FM, thus we examine the risk of self-reported fibromyalgia given selected lifestyle factors. METHODS We used data from 75,485 participants in the Norwegian Women and Cancer study. Information on FM and the lifestyle factors body mass index (BMI), physical activity level, smoking status/intensity, and alcohol consumption were obtained from baseline and follow-up questionnaires. We used Cox proportional hazards model to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS After a median follow-up time of 10 years, we observed 2,248 cases of self-reported fibromyalgia. Overweight (BMI 25-29.9 kg/m2) and obese (BMI ≥ 30 kg/m2) women had a relative risk of 1.34 (95% CI 1.21-1.47) and 1.62 (95% CI 1.41-1.87), respectively, compared to women with normal weight (BMI 18.5-24.9 kg/m2). Very low physical activity level (1-2) was associated with a 31% higher risk of self-reported fibromyalgia (HR 1.31, 95% CI 1.09-1.57) when compared to moderate physical activity level (5-6). There was a strong dose-response relationship between smoking status/intensity and self-reported fibromyalgia (p for trend < 0.001). Compared with moderate alcohol consumption (4.0-10 g/day), the risk of self-reported FM was 72% (HR 1.72; 95% CI 1.45-2.03) higher among teetotallers, and 38% (HR 1.38, 95% CI 1.23-1.54) higher among those with low consumption (0.1-3.9 g/day). CONCLUSIONS Overweight and obesity, very low physical activity level, smoking, and alcohol consumption were associated with an increased risk of self-reported FM.
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Affiliation(s)
- Faith Owunari Benebo
- Department of Community Medicine, UiT The Artic University of Norway, Tromsø, Norway.
| | - Marko Lukic
- Department of Community Medicine, UiT The Artic University of Norway, Tromsø, Norway
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Lee CH, Lee EY, Yang M, Won HS, Kim YD. The current status of fibromyalgia in Korea: an electronic population health data study in Korea. Korean J Pain 2023; 36:458-464. [PMID: 37752664 PMCID: PMC10551395 DOI: 10.3344/kjp.23204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/16/2023] [Accepted: 08/29/2023] [Indexed: 09/28/2023] Open
Abstract
Background Fibromyalgia (FM) is a complex disorder characterized by widespread chronic pain and tenderness in the muscles, ligaments, and soft tissues. It is a chronic pain condition often accompanied by other symptoms and comorbidities. To effectively manage FM, it is crucial to obtain fundamental epidemiological data pertaining to the target population. Therefore, this study was conducted to elucidate the epidemiological characteristics of FM in the Korean population. Methods Population-based medical data of 51,276,314 subscribers to the National Health Insurance Service of Korea from 2014 to 2018 were used in this study. Results The overall incidence of FM ranged from 441 (2014) to 541 (2018) cases per 100,000 person-years, with a higher prevalence observed among female patients compared to male patients. The incidence gradually increased until middle age, followed by a decrease. The highest incidence rates were observed in the fifth decade of life for females and the sixth decade of life for males. When categorizing the affected parts of the body, the shoulder region was observed to be the most frequently affected. A comparison of the drug prescriptions based on medical specialty showed that antidepressants were the most commonly prescribed medications. The management of FM leads to consistent increases in medical expenses, regional disparities, and variations in prescription patterns across different medical specialties. Conclusions The findings of this study will not only contribute to the understanding of FM characteristics but also provide a vital foundation for efficient management of FM in Korea.
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Affiliation(s)
- Cheol-Hyeong Lee
- Department of Anesthesiology and Pain Medicine, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
| | - Eun Young Lee
- Health Insurance Review and Assessment Service, Gwangju, Korea
| | - Miyoung Yang
- Department of Anatomy, Wonkwang University School of Medicine, Iksan, Korea
- Jesaeng-Euise Clinical Anatomy Center, Wonkwang University School of Medicine, Iksan, Korea
- Sarcopenia Total Solution Center, Wonkwang University School of Medicine, Iksan, Korea
| | - Hyung-Sun Won
- Department of Anatomy, Wonkwang University School of Medicine, Iksan, Korea
- Jesaeng-Euise Clinical Anatomy Center, Wonkwang University School of Medicine, Iksan, Korea
| | - Yeon-Dong Kim
- Department of Anesthesiology and Pain Medicine, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
- Jesaeng-Euise Clinical Anatomy Center, Wonkwang University School of Medicine, Iksan, Korea
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Marino C, Grimaldi M, Sabatini P, Amato P, Pallavicino A, Ricciardelli C, D’Ursi AM. Fibromyalgia and Depression in Women: An 1H-NMR Metabolomic Study. Metabolites 2021; 11:429. [PMID: 34209136 PMCID: PMC8304744 DOI: 10.3390/metabo11070429] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/15/2021] [Accepted: 06/23/2021] [Indexed: 12/18/2022] Open
Abstract
Fibromyalgia is a chronic and systemic syndrome characterized by muscle, bone, and joint pain. It is a gender-specific condition with a 9:1 incidence ratio between women and men. Fibromyalgia is frequently associated with psychic disorders affecting the cognitive and emotional spheres. In the reported work, we compared 31 female fibromyalgia patients to 31 female healthy controls. They were analyzed for biochemical clinical parameters, for autoimmune markers, and were subjected to 1H-NMR metabolomics analysis. To identify a correlation between the metabolomic profile and the psychic condition, a subset of 19 fibromyalgia patients was subjected to HAM-A and HAM-D Hamilton depression tests. Multivariate statistical analysis showed the dysmetabolism of several metabolites involved in energy balance that are associated with systemic inflammatory conditions. The severity of depression worsens dysmetabolic conditions; conversely, glycine and glutamate, known for their critical role as neuromodulators, appear to be potential biomarkers of fibromyalgia and are associated with different severity depression conditions.
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Affiliation(s)
- Carmen Marino
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 84084 Fisciano, Italy; (C.M.); (M.G.); (A.P.); (C.R.)
| | - Manuela Grimaldi
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 84084 Fisciano, Italy; (C.M.); (M.G.); (A.P.); (C.R.)
| | - Paola Sabatini
- U.O.C. Clinical Pathology D.E.A. III Umberto I, Viale S. Francesco D’Assisi, 84014 Nocera Inferiore, Italy;
| | - Patrizia Amato
- ASL Ser. T Cava de’ Tirreni, Piazza Matteo Galdi 1/3, 84013 Pregiato, Italy;
| | - Arianna Pallavicino
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 84084 Fisciano, Italy; (C.M.); (M.G.); (A.P.); (C.R.)
| | - Carmen Ricciardelli
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 84084 Fisciano, Italy; (C.M.); (M.G.); (A.P.); (C.R.)
| | - Anna Maria D’Ursi
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II, 84084 Fisciano, Italy; (C.M.); (M.G.); (A.P.); (C.R.)
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A review of the incidence and risk factors for fibromyalgia and chronic widespread pain in population-based studies. Pain 2020; 161:1169-1176. [DOI: 10.1097/j.pain.0000000000001819] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Arnold LM, Bennett RM, Crofford LJ, Dean LE, Clauw DJ, Goldenberg DL, Fitzcharles MA, Paiva ES, Staud R, Sarzi-Puttini P, Buskila D, Macfarlane GJ. AAPT Diagnostic Criteria for Fibromyalgia. THE JOURNAL OF PAIN 2019; 20:611-628. [DOI: 10.1016/j.jpain.2018.10.008] [Citation(s) in RCA: 148] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/28/2018] [Accepted: 10/15/2018] [Indexed: 01/08/2023]
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Gümüş Atalay S. The Association of IGF-1 with Clinical Symptoms in Female Patients With Fibromyalgia Syndrome. ANKARA MEDICAL JOURNAL 2018. [DOI: 10.17098/amj.448386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
Fibromyalgia is a disorder that is part of a spectrum of syndromes that lack precise classification. It is often considered as part of the global overview of functional somatic syndromes that are otherwise medically unexplained or part of a somatization disorder. Patients with fibromyalgia share symptoms with other functional somatic problems, including issues of myalgias, arthralgias, fatigue and sleep disturbances. Indeed, there is often diagnostic and classification overlap for the case definitions of a variety of somatization disorders. Fibromyalgia, however, is a critically important syndrome for physicians and scientists to be aware of. Patients should be taken very seriously and provided optimal care. Although inflammatory, infectious, and autoimmune disorders have all been ascribed to be etiological events in the development of fibromyalgia, there is very little data to support such a thesis. Many of these disorders are associated with depression and anxiety and may even be part of what has been sometimes called affected spectrum disorders. There is no evidence that physical trauma, i.e., automobile accidents, is associated with the development or exacerbation of fibromyalgia. Treatment should be placed on education, patient support, physical therapy, nutrition, and exercise, including the use of drugs that are approved for the treatment of fibromyalgia. Treatment should not include opiates and patients should not become poly pharmacies in which the treatment itself can lead to significant morbidities. Patients with fibromyalgia are living and not dying of this disorder and positive outlooks and family support are key elements in the management of patients.
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Affiliation(s)
- Andrea T Borchers
- Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, 451 Health Sciences Drive, Suite 6510, Davis, CA, 95616, USA
| | - M Eric Gershwin
- Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, 451 Health Sciences Drive, Suite 6510, Davis, CA, 95616, USA.
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Rasouli O, Stensdotter AK, Van der Meer ALH. TauG-guidance of dynamic balance control during gait initiation in patients with chronic fatigue syndrome and fibromyalgia. Clin Biomech (Bristol, Avon) 2016; 37:147-152. [PMID: 27474799 DOI: 10.1016/j.clinbiomech.2016.07.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 07/10/2016] [Accepted: 07/21/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Impaired postural control has been reported in static conditions in chronic fatigue syndrome and fibromyalgia, but postural control in dynamic tasks have not yet been investigated. Thus, we investigated measurements from a force plate to evaluate dynamic balance control during gait initiation in patients with chronic fatigue syndrome and fibromyalgia compared to matched healthy controls. METHODS Thirty female participants (10 per group) performed five trials of gait initiation. Center of pressure (CoP) trajectory of the initial weight shift onto the supporting foot in the mediolateral direction (CoPX) was analyzed using General Tau Theory. We investigated the hypothesis that tau of the CoPX motion-gap (τCoPx) is coupled onto an intrinsic tauG-guide (τG) by keeping the relation τCoPx=KτG, where K is a scaling factor that determines the relevant kinematics of a movement. FINDINGS Mean K values were 0.57, 0.55, and 0.50 in fibromyalgia, chronic fatigue syndrome, and healthy controls, respectively. Both patient groups showed K values significantly higher than 0.50 (P<0.05), indicating that patients showed poorer dynamic balance control, CoPX colliding with the boundaries of the base of support (K>0.5). INTERPRETATION The findings revealed a lower level of dynamic postural control in both fibromyalgia and chronic fatigue syndrome compared to controls.
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Affiliation(s)
- Omid Rasouli
- Institute of Health Science, Faculty of Health and Social Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Ann-Katrin Stensdotter
- Institute of Health Science, Faculty of Health and Social Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Audrey L H Van der Meer
- Developmental Neuroscience Laboratory, Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
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Effects of music on pain in patients with fibromyalgia. Clin Rheumatol 2015; 35:1317-21. [DOI: 10.1007/s10067-015-3046-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 07/29/2015] [Indexed: 10/23/2022]
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Kinge JM, Knudsen AK, Skirbekk V, Vollset SE. Musculoskeletal disorders in Norway: prevalence of chronicity and use of primary and specialist health care services. BMC Musculoskelet Disord 2015; 16:75. [PMID: 25887763 PMCID: PMC4392859 DOI: 10.1186/s12891-015-0536-z] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 03/20/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Uncertainty exists with regards to the extent of prevalence and health care use for musculoskeletal disorders in Norway. The aim of this study was to estimate the prevalence of chronic musculoskeletal disorders and to estimate the prevalence of persons receiving primary and specialist health services for these disorders. METHODS We used three data-sources. First, four discrete years of the nationally representative cross-sectional Survey of Health and Living Conditions (SHLC) conducted in 2002, 2005, 2008 and 2012 by Statistics Norway. Second, we used the Norwegian Patient Registry (NPR) to estimate the proportion of the population who used specialist health services in 2012. Third, we used the national register dataset for reimbursement of primary care physicians, chiropractors and physiotherapists (KUHR) to estimate the proportion of the population attending primary care physicians, chiropractors or physiotherapists in 2012. Age- and sex-specific prevalence/utilization estimates for musculoskeletal disorders were calculated. RESULTS In 2012, 18% of men and 27% of women reported musculoskeletal disorders lasting for six months or more in the SHLC. Primary health care services reimbursed for musculoskeletal disorders were used by 37% of women and 30% of men. Of these 32% (women) and 26% (men) were physician contacts and between 5 and 9% physiotherapist or chiropractor or combined contact types. Corresponding numbers for specialist services were 5% in men and 7% in women, where the majority was out-patient consultations. Low back and neck pain were the most common diagnoses both in the general population and as reason for health care utilization. We found that musculoskeletal disorders increased with age, however our results showed no variation in prevalence of chronic disorders between 2002 and 2012. CONCLUSION Chronic musculoskeletal disorders were common in the general population, with higher prevalence among women compared to men, and increasing prevalence with age. Musculoskeletal disorders had considerable impact on the use of primary and specialist health services in Norway. The use of register data on health service utilization may be a useful source for monitoring population trends, and for estimating the burden in terms of health and health service use.
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Affiliation(s)
- Jonas Minet Kinge
- Norwegian Institute of Public Health, Postboks 4404 Nydalen, 0403, Oslo, Norway.
- Department of Health Management and Health Economics, University of Oslo, Boks 1072, 0316, Oslo, Norway.
| | - Ann Kristin Knudsen
- Norwegian Institute of Public Health, Postboks 4404 Nydalen, 0403, Oslo, Norway.
- Department of Global Public Health and Primary Care, University of Bergen, Postboks 7800, 5020, Bergen, Norway.
| | - Vegard Skirbekk
- Norwegian Institute of Public Health, Postboks 4404 Nydalen, 0403, Oslo, Norway.
- Columbia Aging Center, Columbia University, 722 W. 168th Street, New York, NY, 10032, USA.
| | - Stein Emil Vollset
- Norwegian Institute of Public Health, Postboks 4404 Nydalen, 0403, Oslo, Norway.
- Department of Global Public Health and Primary Care, University of Bergen, Postboks 7800, 5020, Bergen, Norway.
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Abstract
Studying the epidemiology of fibromyalgia (FM) is very important to understand the impact of this disorder on persons, families and society. The recent modified 2010 classification criteria of the American College of Rheumatology (ACR), without the need of tender points palpation, allows that larger and nationwide surveys may be done, worldwide. This article reviews the prevalence and incidence studies done in the general population, in several countries/continents, the prevalence of FM in special groups/settings, the association of FM with some sociodemographic characteristics of the population, and the comorbidity of FM with others disorders, especially with headaches.
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Mengshoel AM. Physiotherapy Management of Fibromyalgia: What do we know and how may this Affect Clinical Practice? PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/ptr.2000.5.2.85] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Warren JW, Langenberg P, Clauw DJ. The number of existing functional somatic syndromes (FSSs) is an important risk factor for new, different FSSs. J Psychosom Res 2013; 74:12-7. [PMID: 23272983 DOI: 10.1016/j.jpsychores.2012.09.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 09/05/2012] [Accepted: 09/06/2012] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The objective of this study is to test the hypothesis that the number of functional somatic syndromes (FSSs) predicts new, additional FSSs. METHODS In a recent case-control study of interstitial cystitis/painful bladder syndrome (IC/PBS), we used symptom-based consensus definitions to identify these FSSs: fibromyalgia (FM), chronic fatigue syndrome (CFS), irritable bowel syndrome (IBS), chronic pelvic pain, migraine, sicca syndrome and panic disorder. Those present before the incidence year were called antecedent FSSs; those with onset during the incidence year were called incident FSSs. In each of two groups, 312 IC/PBS cases and 313 controls, rates of incident FSSs were compared among those with 0, 1, 2, or ≥3 antecedent FSSs. Confounding was assessed using logistic regression analyses that included the individual antecedent FSSs, published correlates of these FSSs, and demographic variables. RESULTS The incidence of a new FSS increased with the number of antecedent FSSs, as did that of incident FM, CFS and IBS studied separately. These findings were not confounded by other variables. The presence of multiple antecedent FSSs generally had the highest odds ratio for new, different, incident FSSs. CONCLUSIONS This study revealed that the number of antecedent FSSs was among the strongest risk factors for other FSSs, especially incident FM, CFS and IBS. This suggests that the FSSs are linked through a polysyndromic phenotype. If each FSS is heterogeneous, to seek a pathogenesis common to all FSSs, individuals with multiple FSSs should be sought; to seek a pathogenesis unique to a specific FSS, mature persons who have only that FSS should be studied.
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Affiliation(s)
- John W Warren
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
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Marrie RA, Yu BN, Leung S, Elliott L, Warren S, Wolfson C, Tremlett H, Blanchard J, Fisk JD. The incidence and prevalence of fibromyalgia are higher in multiple sclerosis than the general population: A population-based study. Mult Scler Relat Disord 2012; 1:162-7. [DOI: 10.1016/j.msard.2012.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Revised: 05/09/2012] [Accepted: 06/12/2012] [Indexed: 12/01/2022]
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Junior MH, Goldenfum MA, Fávaro Siena CA. Fibromialgia: aspectos clínicos e ocupacionais. Rev Assoc Med Bras (1992) 2012. [DOI: 10.1590/s0104-42302012000300018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Junior MH, Goldenfum MA, Fávaro Siena CA. Fibromyalgia: clinical and occupational aspects. Rev Assoc Med Bras (1992) 2012. [DOI: 10.1016/s0104-4230(12)70208-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Abstract
Research in fibromyalgia has increased understanding of the possible genetic and environmental factors that could be involved in the etiology of fibromyalgia. There is now substantial evidence for augmentation of central pain processing in fibromyalgia. Because the clinical presentation of fibromyalgia is heterogeneous, treatment recommendations must be individualized for each patient. The rapid growth of trials in fibromyalgia in recent years has resulted in new evidence-based approaches to pharmacological and nonpharmacological treatment.
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Affiliation(s)
- Lesley M Arnold
- Women's Health Research Program, Department of Psychiatry, University of Cincinnati College of Medicine, 222 Piedmont Avenue, Suite 8200, Cincinnati, OH 45219, USA.
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Choi CJ, Knutsen R, Oda K, Fraser GE, Knutsen SF. The association between incident self-reported fibromyalgia and nonpsychiatric factors: 25-years follow-up of the Adventist Health Study. THE JOURNAL OF PAIN 2010; 11:994-1003. [PMID: 20400378 DOI: 10.1016/j.jpain.2010.01.267] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Revised: 12/07/2009] [Accepted: 01/21/2010] [Indexed: 12/12/2022]
Abstract
UNLABELLED The purpose of the study was to investigate the association between incident self-reported fibromyalgia (FM) and prior somatic diseases, lifestyle factors, and health behaviors among 3,136 women who participated in 2 cohort studies 25 to 26 years apart (the Adventist Health Study 1 and 2). The women completed a comprehensive lifestyle and medical history questionnaire at baseline in 1976. Information on new diagnosis of doctor-told FM was obtained at the second survey in 2002. A total of 136 women reported a diagnosis of FM during 25 years of follow-up, giving a period incidence of 43/1,000 or 1.72/1000 per year. In multivariable logistic regression analyses, a significant, dose-response association was found with number of allergies with OR of 1.61 (95% CI: .92-2.83) and 3.99 (95% CI: 2.31-6.88), (P[trend] < .0001), respectively, for 1 and 2 or more allergies versus none. A history of hyperemesis gravidarum was also associated with FM with OR of 1.32 (95% CI: .75-2.32) and 1.73 (95% CI: .99-3.03), (P[trend] < .05), respectively, for some or all pregnancies versus none. A positive association with smoking was also found with OR of 2.37 (95% CI: 1.33-4.23) for ever smokers versus never smokers. No significant association was found with number of surgeries, history of peptic ulcer, or taking medications to control various symptoms. PERSPECTIVE Smoking as well as prevalent allergies, and a history of hyperemesis gravidarum, seem to predict development of FM in women during 25 years of follow-up. This information may help in identifying persons at high risk of developing FM and thus initiate effective prevention strategies.
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Affiliation(s)
- Chan-Jin Choi
- Department of Epidemiology and Biostatistics, School of Public Health, Loma Linda University, Loma Linda, California 92399, USA
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HAQ SA, DARMAWAN J, ISLAM MN, AHMED M, BANIK SK, Fazlur Rahman AKM, ALAM MN, TAHIR M, RASKER JJ. Incidence of musculoskeletal pain and rheumatic disorders in a Bangladeshi rural community: a WHO-APLAR-COPCORD study. Int J Rheum Dis 2008. [DOI: 10.1111/j.1756-185x.2008.00364.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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The prevalence of generalized soft tissue rheumatic conditions in Turkish medical students. J Clin Rheumatol 2008; 14:65-8. [PMID: 18391672 DOI: 10.1097/rhu.0b013e31816b1920] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To assess the prevalence of generalized soft tissue rheumatism (GSTR) in medical students in Izmir, Turkey. METHODS Medical students from each grade of Medical School of Ege University, Izmir, Turkey, were evaluated by a survey and physical examination for GSTR including fibromyalgia (FM) syndrome, myofascial pain syndrome (MPS), benign joint hypermobility syndrome (BJHS), and chronic fatigue syndrome. FM Impact Questionnaire was assessed in FM diagnosed students. Short Form-36 (SF-36) was obtained from each student to determine the quality of life. RESULTS Among the participants (n = 306), 191 were women (62.4%) and 115 were men (37.6%) and mean age was 20.23 +/- 1.56. Fifty-eight students (19%) were diagnosed with a GSTR. The distributions of the diagnoses were: 6 (2%) FM, 21 (6.9%) MPS, 28 (9.2%) BJHS, 1 (0.3%) chronic fatigue syndrome, and 2 students (0.7%) had both BJHS and MPS. Fifty-three (27.7%) women and 5 (4.3%) men were diagnosed with a GSTR (P < 0.01). Mean FM Impact Questionnaire score was 50.8 in FM diagnosed students. Physical role, vitality, and mental subscores of SF-36 were significantly lower in the students having a GSTR (P < 0.05). CONCLUSION This is the first study performed in medical students to find out the prevalence of generalized soft tissue rheumatic conditions. Although medical students are under high stress due to hard training, the prevalence of GSTR in medical students was found similar to previous reports in the general population.
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Weir PT, Harlan GA, Nkoy FL, Jones SS, Hegmann KT, Gren LH, Lyon JL. The Incidence of Fibromyalgia and Its Associated Comorbidities. J Clin Rheumatol 2006; 12:124-8. [PMID: 16755239 DOI: 10.1097/01.rhu.0000221817.46231.18] [Citation(s) in RCA: 208] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND The epidemiology of fibromyalgia is poorly defined. The incidence of fibromyalgia has not been determined using a large population base. Previous studies based on prevalence data demonstrated that females are 7 times more likely to have fibromyalgia than males and that the peak age for females is during the childbearing years. OBJECTIVE We have calculated the incidence rate of fibromyalgia in a large, stable population and determined the strength of association between fibromyalgia and 7 comorbid conditions. METHODS We conducted a retrospective cohort study of a large, stable health insurance claims database (62,000 nationwide enrollees per year). Claims from 1997 to 2002 were examined using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes to identify fibromyalgia cases (ICD code 729.1) and 7 predetermined comorbid conditions. RESULTS A total of 2595 incident cases of fibromyalgia were identified between 1997 and 2002. Age-adjusted incidence rates were 6.88 cases per 1000 person-years for males and 11.28 cases per 1000 person-years for females. Females were 1.64 times (95% confidence interval = 1.59-1.69) more likely than males to have fibromyalgia. Patients with fibromyalgia were 2.14 to 7.05 times more likely to have one or more of the following comorbid conditions: depression, anxiety, headache, irritable bowel syndrome, chronic fatigue syndrome, systemic lupus erythematosus, and rheumatoid arthritis. CONCLUSION Females are more likely to be diagnosed with fibromyalgia than males, although to a substantially smaller degree than previously reported, and there are strong associations for comorbid conditions that are commonly thought to be associated with fibromyalgia.
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Affiliation(s)
- Peter T Weir
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah 84108, USA.
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Gamero Ruiz F, Gabriel Sánchez R, Carbonell Abello J, Tornero Molina J, Sánchez-Magro I. El dolor en las consultas de Reumatología españolas: estudio epidemiológico EPIDOR. Rev Clin Esp 2005; 205:157-63. [PMID: 15860186 DOI: 10.1157/13074161] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To establish the prevalence and characteristics of rheumatologic pain in Spanish adult population cared in specialized rheumatology offices. DESIGN Cross selection study in a population of patients cared in rheumatology offices of public Spanish hospitals. SUBJECTS 1,134 patients selected through random sampling based on waiting lists of patients, during a period of 1 week, in rheumatology offices of each participating hospital. MAIN OUTCOMES OF THE STUDY: Reason behind the consultation (a new patient [NP] or a patient for revision [RP]), characteristics of the patient (sex, age, habits [alcohol/tobacco], marital status), location, type, intensity, duration, tolerance and management of pain; treatment (pharmacological or non-pharmacological) carried out; satisfaction with the treatment; and association with fibromyalgia. RESULTS The prevalence of pain in NP was 98.6% and in RP 95.1%, with a global prevalence of 96%, predominating mainly in adult sedentary women with fibromyalgia. The frequency of acute pain was 20.9% and this of chronic pain 79.1% [corrected] The prevalence of fibromyalgia was 12% (2.2% in men, and 15.5% in women). The most prevalent pattern of current dominant pain was this of the mechanical type. More frequent associated pathologies were: hypertension (21.7%), depression (14.4%), gastrointestinal diseases (13.8%) and anxiety (13.4%). All variables analyzed in the study showed changes according to age, sex, and type of patient (NP or RP). Most used treatment was pharmacological; more than 57.6% of patients were receiving NSAIDs. In NP, medical prescriber of the treatment was first the general practitioner (56.1%) followed by the rheumatologist (14.1%); in PR the first one was the rheumatologist (69.9%) followed by the general practitioner (16.5%). CONCLUSIONS Our results show that the prevalence of the rheumatologic pain is very high, predominating mainly in adult women with fibromyalgia. Pain location, intensity, and type, associated pathology, and treatment vary according to age, sex, and type of patient. The most commonly used drugs for pain management were NSAIDs (58%); opiodes were only used in 6.4% of patients even though pain was intense in more than two-thirds.
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Affiliation(s)
- F Gamero Ruiz
- Servicio de Epidemiología, Hospital Universitario de La Princesa, Madrid
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Lemstra M, Olszynski WP. The Effectiveness of Multidisciplinary Rehabilitation in the Treatment of Fibromyalgia. Clin J Pain 2005; 21:166-74. [PMID: 15722810 DOI: 10.1097/00002508-200503000-00008] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To assess the effectiveness of multidisciplinary rehabilitation in the treatment of fibromyalgia in comparison to standard medical care. METHODS Seventy-nine men and women were randomly assigned to one of two groups. The intervention group consisted of a rheumatologist and physical therapist intake and discharge, 18 group supervised exercise therapy sessions, 2 group pain and stress management lectures, 1 group education lecture, 1 group dietary lecture, and 2 massage therapy sessions. The control group consisted of standard medical care with the patients' family physician. Outcome measures included self-perceived health status, pain-related disability, average pain intensity, depressed mood, days in pain, hours in pain, prescription and nonprescription medication usage, and work status. Outcomes were measured at the end of the 6-week intervention and at 15-month follow-up. RESULTS Thirty-five out of 43 patients from the intervention group and 36 out of 36 patients from the control group completed the study. There were no statistically significant differences between the 2 groups prior to intervention. Intention-to-treat analysis revealed that the intervention group, in comparison to the control group, experienced statistically significant changes at intervention completion in self-perceived health status, average pain intensity, pain related disability, depressed mood, days in pain, and hours in pain, but no significant differences in nonprescription drug use, prescription drug use, or work status. At 15 months, all health outcomes retained their significance except health status. Nonprescription and prescription drug use demonstrated significant reductions at 15 months. Binary logistic regression indicated that long-term changes in Pain Disability Index were influenced by long-term exercise adherence and income status. CONCLUSIONS Positive health-related outcomes in this mostly unresponsive condition can be obtained with a low-cost, group multidisciplinary intervention in a community-based, nonclinical setting.
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Affiliation(s)
- Mark Lemstra
- College of Medicine, University of Saskatchewan, Saskatoon, Canada
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Abstract
Chronic widespread pain, the cardinal symptom of fibromyalgia (FM), is common in the general population, with comparable prevalence rates of 7.3% to 12.9% across different countries. The prevalence of FM in the general population was reported to range from 0.5% to 5% and up to 15.7% in the clinic. The common association of FM with other rheumatic disorders, chronic viral infections, and systemic illnesses has been well documented in several studies. Up to 65% of patients with systemic lupus erythematosus meet the criteria for FM. FM is considered a member of the family of functional somatic syndromes. These syndromes are very common and share a similar phenomenology, epidemiologic characteristics, high rates of occurrence, a common pathogenesis, and similar management strategies. A high prevalence of FM was demonstrated among relatives of patients with FM and it may be attributed to genetic and environmental factors.
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Affiliation(s)
- Lily Neumann
- Department of Epidemiology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
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Abstract
Chronic widespread musculoskeletal pain has been subjected to several epidemiological studies during the last decade. According to these, approximately 10% of the general population report such complaints, clearly indicating chronic widespread musculoskeletal pain as a major health problem in the Western world. Almost unanimously, all studies found higher rates of such complaints among women compared with men, but the mechanisms responsible for the skewed gender ratio remain unknown.Chronic widespread musculoskeletal pain is the clinical hallmark of fibromyalgia and has been the subject of numerous epidemiological studies. The prevalence of fibromyalgia is reportedly 3-5%, again with a significant female predominance. Although the aetiopathogenesis of both fibromyalgia and chronic widespread musculoskeletal pain without other features of fibromyalgia remains an enigma, there is a body of evidence suggesting psychological and sociocultural factors as important for contracting such pain syndromes.
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Affiliation(s)
- Jan Tore Gran
- Department of Rheumatology, National Hospital Rikshospitalet, Sognsvannsveien, Oslo, Norway.
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Abstract
Soft tissue rheumatism forms a broad spectrum of health problems, most of them poorly defined according to diagnostic criteria and case definitions. In this chapter the most prevalent conditions, low back pain, neck pain, shoulder pain, arm/wrist/hand conditions and widespread pain, are discussed. A better term for referring to these health problems is regional and widespread pain disorders. The prevalence and the impact on health care and society of these conditions is high. Many physical, psychosocial and work-related factors play a role in aetiology and prognosis. A good prevention policy does not exist for most conditions due to the lack of knowledge on risk factors, risk groups and trends. To improve the epidemiological research on regional and widespread pain disorders, research should focus on clear and relevant definitions of cases or pain subgroups and on specific risk factors.
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Affiliation(s)
- Bård Natvig
- University of Oslo, Institute of General Practice and Community Medicine, PO Box 1130, Blindern, N0318, Oslo, Norway
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Mäkelä MO. Is fibromyalgia a distinct clinical entity? The epidemiologist's evidence. Best Pract Res Clin Rheumatol 1999; 13:415-9. [PMID: 10562371 DOI: 10.1053/berh.1999.0030] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The key features of fibromyalgia are chronic widespread pain, general distress and enhanced pain sensitivity as revealed by a tender point count. Fibromyalgia could be considered a distinct entity if the key features defined a patient group with any one of the following: a characteristics feature or cluster of features with a distribution clearly demarcating the group from the rest of the population, identifiable risk factors, a characteristic natural course or prognosis, or a specific response to treatment. This should be seen in population studies, not only in selected clinic series. The available epidemiological evidence suggests that the distributions of the key features are continuous and no clear population groups can be defined. Also, difficulties in identifying changes such as incidence and recovery, and unreliable measurements of the key features themselves, detract from the utility of the concept of fibromyalgia as an epidemiological entity.
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Affiliation(s)
- M O Mäkelä
- National Public Health Institute, Department of Health and Disability, Helsinki, Finland
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Abstract
Fibromyalgia was almost completely absent from an urban affluent population compared with poor urban and rural communities. Seventeen percent of Gulf War veterans with soft tissue syndromes had fibromyalgia, a much higher rate than was seen in previous studies of rheumatic disease in the military population. A state of central hyperexcitability in the nociceptive system was reported in fibromyalgia. Altered functioning of the stress-response system has been further documented in fibromyalgia and chronic fatigue syndrome. Administration of growth hormone to patients with fibromyalgia who have low levels of insulin-like growth factor 1 resulted in improvement in their symptoms and tenderness. An association between chronic fatigue syndrome and initial infections was demonstrated. A correlation between particular immunologic abnormalities and measures of disease severity was documented in chronic fatigue syndrome. Concomitant fibromyalgia in other rheumatic diseases was a major contributor to poor quality of life. A favorable outcome of fibromyalgia in children was reported; the majority of patients improved over 2 to 3 years of follow-up. Treatment of patients with fibromyalgia continues to be of limited success.
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Affiliation(s)
- D Buskila
- Department of Medicine B, Soroka Medical Center, Beer Sheva, Israel
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