This may be the symptom of premature death, According to a new study.

A new study published today says that people who are suffering from this type of chronic pain may have a higher risk of dying early by accidents, infections, and especially suicide.

A comprehensive analysis of available evidence, published in the open-access journal RMD Open, suggests that Fibromyalgia, a condition characterized by persistent widespread pain and fatigue, may be associated with an increased risk of death.

The study indicates that individuals with fibromyalgia may be more vulnerable to accidents, infections, and particularly suicide.

They stress the importance of regularly monitoring the physical and mental health of fibromyalgia patients to mitigate these risks. Although the exact cause of fibromyalgia remains unclear, its prevalence is on the rise. Additionally, there is growing awareness that the condition frequently coexists with other health issues such as rheumatic, gastrointestinal, neurological, and mental disorders.

Due to the significant pain experienced by fibromyalgia patients and the likelihood of other painful and debilitating conditions, it is believed that they face an elevated risk of premature death. To support this hypothesis, the team reviewed eight relevant studies published between 1999 and 2020, selected from an initial pool of 33 studies.

Out of the six studies they pooled together, involving a total of 188,751 adults with coexisting conditions, the analysis revealed that fibromyalgia was associated with a 27% increased risk of death from all causes over time. However, this association was not observed in those diagnosed based on the 1990 criteria.

The diagnostic criteria for fibromyalgia have evolved since 1990, aligning with a better understanding of the broad range of clinical symptoms associated with the condition. Consequently, the criteria were revised in 2010, 2011, and 2016, as highlighted by the researchers.

Specifically, the analysis indicated that the risk of death from cancer was 12% lower compared to the general population of the same age, and only slightly higher (5%) for accidents. However, the risk was 44% higher for infections, including pneumonia and septicaemia, and over three times higher for suicide.

It remains uncertain whether this heightened risk is directly caused by fibromyalgia itself or the concomitant conditions. The team emphasizes the importance of addressing this issue in future research. They also caution that their findings should be interpreted with caution due to variations in study designs and the limited number of participants in the studies included in their analysis.

“Due to significant heterogeneity across the studies, which were also small in number, no clear conclusions can be drawn from the available data,” they said. “However, it is possible that for the subgroup of patients diagnosed by the 1990 criteria there is no increased risk for mortality, and for those diagnosed by later versions the risk is increased.”

The researchers suggest plausible explanations for their findings. They propose that the increased mortality associated with accidents may stem from fatigue, poor sleep, and concentration difficulties often experienced by individuals with fibromyalgia, which have been included as diagnostic criteria since 2010.

Furthermore, mounting evidence supports the involvement of the immune system and inflammation in the pathophysiology of fibromyalgia, which may explain the increased mortality from infections. Physical comorbidity could be an additional contributing factor.

“More and more evidence supports immune system involvement and inflammation in fibromyalgia pathophysiology, which can explain the finding of increased mortality from infections. Physical comorbidity may be an additional explanation.”

They suggest that the decreased risk of death from cancer in these patients may be attributed to their frequent utilization of healthcare services.

The risks identified in this analysis highlight a potentially significant public health concern due to the high prevalence of fibromyalgia. However, clinicians do not always take this condition seriously.

They note that medical staff often hesitate to accept fibromyalgia as a genuine medical condition, and they encounter emotional and psychological challenges when interacting with these patients and managing their disorder.

Fibromyalgia is frequently labeled as an “imaginary condition,” leading to ongoing debates regarding its legitimacy and clinical relevance. The review serves as further evidence that fibromyalgia patients should be treated seriously, with particular attention given to screening for suicidal ideation, accident prevention, and the prevention and treatment of infections.

Source:10.1136/rmdopen-2023-003005

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