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Pain is not the major determinant of quality of life in fibromyalgia: results from a retrospective “real world” data analysis of fibromyalgia patients

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Abstract

Objective

To identify correlates of quality of life (QoL) measured with the Quality of Life Scale (QOLS) in participants of a multidisciplinary day hospital treatment program for fibromyalgia (FM).

Methods

In this cross-sectional, observational study, “real world” data from 480 FM patients including socio-demographics, pain variables and questionnaires such as the SF-36, Beck Depression Inventory (BDI), Multiphasic Pain Inventory (MPI), SCL-90-R and others were categorized according to the components (body structure and function, activities and participation, personal factors, environmental factors) of the International Classification of Functioning (ICF). For every ICF component, a linear regression analysis with QOLS as the dependent variable was computed. A final comprehensive model was calculated on the basis of the results of the five independent analyses.

Results

The following variables could be identified as main correlates for QoL in FM, explaining 56% of the variance of the QOLS (subscale/questionnaire and standardized beta in parenthesis): depression (− 0.22), pain-related interference with everyday life (− 0.19), general activity (0.13), general health perception (0.11), punishing response from others (− 0.11), work status (− 0.10), vitality (− 0.11) and cognitive difficulties (− 0.12). Pain intensity or frequency was not an independent correlate.

Conclusions

More than 50% of QoL variance could be explained by distinct self-reported variables with neither pain intensity nor pain frequency playing a major role. Therefore, FM treatment should not primarily concentrate on pain but should address multiple factors within multidisciplinary therapy.

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Authors and Affiliations

  1. Department of Orthopedics, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, Germany

    Martin Offenbaecher, Claudia Sigl, Robin Hieblinger, Sybille Kramer & Andreas Winkelmann

  2. Gasteiner Heilstollen Clinic, Heilstollenstr. 19, 5645, Bad Gastein, Austria

    Martin Offenbaecher

  3. Division of Integrative Health Promotion, University of Applied Science and Arts, Coburg, Germany

    Niko Kohls

  4. Bavarian Health and Food Safety Authority, Nuremberg, Germany

    Thomas Ewert

  5. Department of Psychology, Luther College, Decorah, IA, USA

    Loren L. Toussaint

  6. Department of Psychology, University of Sheffield, Sheffield, UK

    Fuschia Sirois

  7. Department of Psychology, East Tennessee State University, Johnson City, USA

    Jameson Hirsch

  8. Psychology Faculty, UNED, Madrid, Spain

    Miguel A. Vallejo

  9. Rheumatology Unit, Rehabilitation Provincial Institute, “Gregorio Marañón” General Hospital, Madrid, Spain

    Javier Rivera

  10. Department Health Sciences and Medicine, University of Luzern, Luzern, Switzerland

    Gerold Stucki

  11. Primary Care Center Martinsried, Munich, Germany

    Jörg Schelling

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  1. Martin Offenbaecher
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  2. Niko Kohls
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Correspondence to Martin Offenbaecher.

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Offenbaecher, M., Kohls, N., Ewert, T. et al. Pain is not the major determinant of quality of life in fibromyalgia: results from a retrospective “real world” data analysis of fibromyalgia patients. Rheumatol Int 41, 1995–2006 (2021). https://doi.org/10.1007/s00296-020-04702-5

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