Most women with fibromyalgia and chronic widespread pain tend to experience less pain over time, which can be boosted by reducing their stress levels, a study suggests.
The findings of the study, “Stress levels predict substantial improvement in pain intensity after 10 to 12 years in women with fibromyalgia and chronic widespread pain: a cohort study,” were published in BMC Rheumatology.
Previous longitudinal studies monitoring the evolution of pain in patients with both disorders have had contradictory results. Some have found that pain escalates over time; others have found that pain decreases over time.
“There is limited knowledge of why some patients achieve substantial improvement in pain over time while others do not. A Swedish postal survey showed that higher health-related quality of life at baseline in persons with chronic pain increased the chances of no longer having chronic pain after three years,” the investigators said.
“On the other hand, factors such as being a woman, having lower education, high body mass index (BMI), higher levels of depression and anxiety, worse sleep, being a former smoker, or having other concomitant disorders have been found to predict an increased risk of still having CWP after 11 years,” they added.
In this study, a group of researchers from the University of Gothenburg in Sweden set out to monitor the evolution of pain and other debilitating symptoms over a decade in a group of women with fibromyalgia or CWP.
The longitudinal, prospective, cohort study (NCT02872129) enrolled 166 women with fibromyalgia or CWP who were followed for 10–12 years.
Most women (76%) participated in the follow-up period and completed a series of questionnaires to determine pain intensity, distribution, health-related quality of life, degree of fatigue, anxiety, stress, and depression.
Results showed there was a significant reduction in pain intensity and distribution, as well as the severity of fatigue, depression, and stress from baseline to the 10- to 12-year follow-up, “which should be communicated to these patients in health care.”
“The mean improvement for pain intensity for the study population was 9 mm on a 100 mm VAS [Visual Analogue Scale], which corresponds to a 13% change from baseline on group level,” the authors wrote.
At the individual level, moderate improvements in pain intensity (30–50% reduction) were seen in 11 (9%) women, while substantial improvements (more than 50% reduction) were found in 20 (16%) women.
Moreover, researchers found that stress seemed to be the most important factor contributing to the overall reduction of pain intensity over time.
“Lower symptoms of stress and higher pain intensity at baseline predicted higher probability of reporting 50% less pain intensity after 10 to 12 years as compared to baseline,” they said.
“Exposure to stress over a long period of time may trigger dysfunctional biological and psychological stress mechanisms which could have a negative impact on the patient’s health and possibilities to recovery. The results of the present study underline the importance of development of treatments and strategies in health care to reduce stress in women with FM and CWP,” they added.