The Link Between Fibromyalgia and Mortality: Unveiling the Disturbing Connection

Fibromyalgia, a chronic condition characterized by widespread pain and fatigue, has been increasingly recognized as potentially co-occurring with various health issues, including rheumatic, gastrointestinal, neurological, and mental disorders. An examination of existing evidence has revealed a potential correlation between fibromyalgia and a heightened risk of mortality, primarily attributed to an increased susceptibility to accidents, infections, and notably, suicide.

According to a pooled data analysis published in the open-access journal RMD Open, fibromyalgia may be associated with an elevated risk of death due to vulnerability to accidents, infections, and especially suicide. The researchers urge the implementation of regular physical and mental health monitoring to mitigate these risks.

While the exact cause of fibromyalgia remains unclear, its prevalence is on the rise, and it is increasingly acknowledged that the condition often coexists with other health ailments, such as rheumatic, gastrointestinal, neurological, and mental disorders.

Given the severe pain experienced by individuals with fibromyalgia and the likelihood of other painful and debilitating conditions, it is believed that they may face an increased risk of premature mortality.

To support this hypothesis, the researchers reviewed eight relevant studies published between 1999 and 2020, out of an initial selection of 33. From the analysis of six studies involving 188,751 adults with coexisting conditions, it was observed that fibromyalgia was associated with a 27% higher risk of death from all causes over time, excluding those diagnosed under the 1990 criteria.

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

The analysis specifically revealed that the risk of death from cancer was 12% lower than that of the general population of the same age, while the risk of death from accidents was only marginally higher (5%). However, the risk of death from infections, including pneumonia and septicemia, was 44% higher, and the risk of suicide was more than three times as high.

The researchers note that it is unclear whether this heightened risk is due to fibromyalgia itself or the concurrent conditions, as their research was not designed to evaluate this. They stress the importance of further research to address this question.

Furthermore, the researchers caution that their findings should be interpreted considering the variations in study designs and the small number of participants included in their analysis.

They state, “Due to significant heterogeneity across the studies, which were also small in number, no clear conclusions can be drawn from the available data. 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 propose plausible explanations for their findings. They suggest that the increased mortality associated with accidents may result from fatigue, disrupted sleep, and difficulties with concentration, which are common symptoms of fibromyalgia since 2010.

They also highlight the mounting evidence supporting the involvement of the immune system and inflammation in the pathophysiology of fibromyalgia, which could explain the elevated mortality risk from infections. Additionally, physical comorbidity may contribute as an additional explanation.

The reduced risk of death from cancer in these patients could be attributed to their extensive use of healthcare services, according to the researchers.

The risks identified in their analysis highlight a significant public health concern due to the high prevalence of fibromyalgia, which clinicians do not always take seriously. The researchers note that medical staff are often hesitant to acknowledge fibromyalgia as a legitimate medical condition and encounter emotional and psychological challenges in interacting with these patients and managing their disorder.

“Fibromyalgia is often labeled as an ‘imaginary condition,’ and debates persist regarding its legitimacy and clinical utility as a diagnosis. Our review provides further evidence that fibromyalgia patients should be treated seriously, with specific attention given to screening for suicidal ideation, accident prevention, and the prevention and treatment of infections,” the researchers conclude.

Reference: “Fibromyalgia and mortality: a systematic review and meta-analysis” by Yulia Treister-Goltzman and Roni Peleg, 10 July 2023, RMD Open. DOI: 10.1136/rmdopen-2023-003005.

Frequently Asked Questions (FAQs) about fibromyalgia mortality risks

More about fibromyalgia mortality risks

• “Fibromyalgia and mortality: a systematic review and meta-analysis” (RMD Open): Link
• “Fibromyalgia: Overview” (Mayo Clinic): Link
• “Fibromyalgia” (National Institute of Arthritis and Musculoskeletal and Skin Diseases): Link