Of patients with fibromyalgia, about one-fourth reported a precipitating event such as an infection or a physical or emotional trauma, according to recently published study findings.
Researchers retrospectively studied 978 patients with fibromyalgia (FM) seen by the authors as part of the fibromyalgia treatment program at the Mayo Clinic. The Fibromyalgia Impact Questionnaire (FIQ) and the SF-36 were administered to patients, who were also asked about history of the presence or absence of a precipitating trauma or infection and whether symptoms were sudden or gradual at onset. Demographics and social variables, alcohol and tobacco use, opiate and NSAID use and other data were collected and used in a multivariate analysis.
A total of 295 patients reported a precipitating trauma prior to onset of FM, 256 of whom reported a physical trauma or infection and were included in the study. Classification of idiopathic FM was applied to the remaining 683 patients with FM and no precipitating event.
A physical trauma was reported by 203 patients, including motor vehicle accidents, surgery, childbirth, falling and other injuries. Infections included Epstein-Barr virus, Borrelia burgdorferi, varicella zoster, other viral infections and nonspecific viral infection and were reported by 53 patients as precipitating factors.
Sudden onset of symptoms was reported by 87.5% of patients who identified a precipitating trauma or infection compared with 5.9% of patients with idiopathic FM. Time to diagnosis was shortest in the group that reported infection at mean 43.3 months compared with 101 months in the patients with idiopathic FM and in 98.5 months in the group that reported trauma.
Patients who reported physical trauma had worse FIQ scores than other groups, and patients who reported infection reported worse physical functioning on the FIQ; however, adjustments for marital status and disease duration showed no significant differences in FIQ score and patient-reported infection, according to the researchers.
Significant differences were seen between the three groups for the SF-36 physical and mental component summaries and mental health index. Worse SF-36 physical functioning was seen in patients with precipitating infection, but better role emotional and mental health index were seen in the same patients, the researchers found.
According to one of the researchers, the results align with some prior studies, but not all.
“In this study, differences between those in the trauma and idiopathic groups were limited to more sudden onset and worse FIQ physical functioning in the trauma group,” study researcher, Terry H. Oh, MD, told Healio.com/Rheumatology. “Those findings contradict previous findings of no difference in FIQ physical functioning between patients with and without traumatic onset but agree with more reduced physical activity in patients with traumatic onset. Similar frequency of precipitating illness or infection has been reported previously in patients with fibromyalgia.” - by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.