Fibromyalgia during COVID-19, anxiety and pain

Early research on the impact of the COVID-19 pandemic has found persistent related anxiety in the general population. Researchers in the UK speculated that this anxiety would be associated with increased pain in chronic pain patients diagnosed with fibromyalgia (FM).

Fibromyalgia affects approximately 2% of the world population. A recent review of the literature showed that the frequency of fibromyalgia in the general population was between 0.2 and 6.6%. It is often reported as being higher in women, with a ratio of three to one.

Fibromyalgia requires long-term care and support. Anxiety and pain are associated with fibromyalgia and have increased with the stress of the ongoing pandemic.

Researchers led by first author AY Kharko of the Faculty of Health, University of Plymouth and others from the School of Psychology, Cardiff University and the Faculty of Life & Health Sciences, Aston University, have published the results of their study on fibromyalgia patients. on the prepress server medRxiv *. Their study is titled “The Anxiety and Pain of Fibromyalgia Patients During the COVID-19 Pandemic”.

background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 19 (COVID-19), has infected over 63.18 million people worldwide and caused more than 1.46 millions of lives.

The COVID-19 pandemic has resulted in a large population suffering from anxiety and related problems. The team of researchers speculated that those with fibromyalgia may have exacerbated pain-related symptoms due to increased anxiety during this pandemic.

Restrictions and anxiety related to the pandemic

SARS-CoV-2 is a highly infectious virus that spreads rapidly among humans. To prevent the spread of the virus, many countries implemented blockades once the pandemic was declared. This restricted the movement of citizens and prevented rallies. These levies were public health measures deemed necessary to reduce the burden on the health system with an increasing number of cases. Over time, however, these restrictions began to affect the mental health of populations.

The authors wrote: “Although the momentous impact of these changes has been widely hypothesized, the negative impact of individual lived experiences on mental and physical well-being must be fully characterized.” As many as 55 percent demonstrated high levels of anxiety, a previous UK study showed.

Distributions of anxiety assessments by source. The first line of the half-violin plot shows the distribution of mean daily anxiety scores (aVASμ). The following lines show the distribution of the ratings by source of anxiety, sorted from highest to lowest average. The number of times a source of anxiety has been selected (across all daily surveys) is shown in parentheses. The mean anxiety score by source is shown to the right of each distribution.

Fibromyalgia and anxiety

Fibromyalgia is a chronic pain condition typically characterized by:

• Chronic musculoskeletal pain
• Fatigue
• Sleep problems and unrefreshing sleep
• Many other problems, including anxiety disorders

Studies have shown that generalized anxiety disorders are seen in about 30% of people living with fibromyalgia. In 60 percent of fibromyalgia sufferers, there are symptoms of anxiety, the authors write. Anxiety correlates with increased pain symptoms in these patients, the team writes.

Study design

This study aimed to examine anxiety symptoms among patients with fibromyalgia and increased pain symptoms. The researchers conducted a 10-day survey of participants diagnosed with fibromyalgia. A total of 58 female participants aged 18 to 60 years were included. These participants had no other pain conditions. The study was conducted between May and June 2020.

Early on, the team identified aspects of the COVID-19 pandemic that increased anxiety symptoms. Participants were asked for a daily assessment of the anxiety and pain symptoms they experienced on a 101-point visual analog scale (VAS). The entire survey was conducted for ten days. On days 2-10, the pain history questions and general anxiety questionnaires were omitted.

The hypothesis was that the source of anxiety in fibromyalgia could be multiple, but the most important was the contraction of the virus. The team speculated that increased COVID-19 anxiety could be associated with increased pain symptoms.

Results

The study results showed that some of the main causes of anxiety among participants with fibromyalgia included:

• The impact of the pandemic and its restrictions on relationships
• Fear of a family member who contracts COVID-19
• Possible financial difficulties
• Fear of access to drugs during the pandemic
• Fear of home loss or eviction

Modeling analysis showed that increased pain was significantly associated with increased anxiety. They took into account other factors such as daily caffeine intake. Other factors associated with pain were the use of mild pain relievers or pain relievers and increasing the participant’s age.

Conclusions and implications

The researchers concluded that pandemic anxiety is present among patients with fibromyalgia, and is also associated with “amplified self-assessed chronic pain”. The daily psychological fluctuations of fibromyalgia patients, the team wrote, were a major determinant of fibromyalgia pain. The team wrote that this study “confirms previously raised concerns that the ‘new normal’ introduced by the pandemic may have a qualitatively different impact on vulnerable populations.” It also confirms the “relationship between mental and physical well-being in FM pain”.

They asked for more studies to look at daily fatigue and sleep assessments, along with anxiety symptoms among fibromyalgia patients. Furthermore, the team explains that this study was conducted during the first months of the pandemic, and the picture could be more severe now after nearly a year of the pandemic. They have now asked for studies on this, saying it would be “beneficial for understanding the long-term development of COVID-19 anxiety in the presence of chronic pain.”

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and therefore should not be considered conclusive, guide clinical practice / health-related behaviors, or treated as consolidated information.