Current Rheumatology Reports

, Volume 7, Issue 5, pp 339–341 | Cite as

Chronic widespread pain and fibromyalgia: Should reports of increased mortality influence management?

  • Gary J. Macfarlane
Article

Abstract

There have been few studies examining whether persons with chronic widespread pain or fibromyalgia are at increased risk for dying prematurely. Among the studies conducted there is little consistency in results. If there is an increased mortality risk, it is of the order of a 30% excess and it may be related to the lifestyle of patients with these symptoms, including lack of exercise. Skilled judgment is required in determining whether reports of new symptoms are likely to indicate underlying new pathology. Studies are currently underway which will determine whether initial observations of an increased mortality risk can be replicated.

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References and Recommended Reading

  1. 1.
    Andersson HI, Ejlertsson G, Leden I, Rosenberg C: Chronic pain in a geographically defined general population: studies of differences in age, gender, social class, and pain localiza-tion. Clin J Pain 1993, 9:174–182.PubMedCrossRefGoogle Scholar
  2. 2.
    Wolfe F, Ross K, Andersson J, et al.: The prevalence and charac-teristics of fibromyalgia in the general population. Arthritis Rheum 1995, 38:19–28. A major population study which demonstrated the age-prevalence pattern of CWP and fibromyalgia, in particular the decreased preva-lence in old age. The origin of the hypothesis about chronic pain symptoms and cancer.PubMedCrossRefGoogle Scholar
  3. 3.
    Croft PR, Burt J, Schollum J, et al.: More pain, more tender points: is fibromyalgia just one end of a continuous spec-trum? Ann Rheum Dis 1996, 55:482–485.PubMedCrossRefGoogle Scholar
  4. 4.
    Thomas E, Peat G, Harris L, et al.: The prevalence of pain and pain interference in a general population of older adults: cross-sectional findings from the North Staffordshire Osteoarthritis (Project(NorStOP). Pain 2004, 110:361–368.A population study which disproved the hypothesis that as persons get older they may be less inclined to report pain (which may be considered by persons to be a natural consequence of ageing). Symptoms at older age were more disabling.PubMedCrossRefGoogle Scholar
  5. 5.
    McBeth J, Harkness EF, Silman AJ, Macfarlane GJ: Is musculo-skeletal pain more common now than 40 years ago? Results from two population-based cross-sectional studies (abstract). Rheumatology 2004, 43:SOP12.Google Scholar
  6. 6.
    Palmer KT, Walsh K, Bendall H, Cooper C, Coggon D: Back pain in Britain: comparison of two prevalence surveys. Br Med J 2000, 320:1552–1553.CrossRefGoogle Scholar
  7. 7.
    Leino PI, Berg MA, Puska P: Is back pain increasing? Results from national surveys in Finland during 1978/9–1992. Scand J Rheumatol 1994, 23:269–273.PubMedGoogle Scholar
  8. 8.
    Heistaro S, Vartianen E, Heliovaara M, Puska P: Trends of back pain in Eastern Finland, 1972–1992, in relation to socioeconomic status and behavioural risk factors. Am J Epidemiol 1998, 148:671–682.PubMedCrossRefGoogle Scholar
  9. 9.
    Macfarlane GJ, McBeth J, Garrow AG, Silman AJ: Life is as much a pain as it ever was. BMJ 2000, 321:897.PubMedCrossRefGoogle Scholar
  10. 10.
    McBeth J, Macfarlane GJ, Hunt IM, Silman AJ: Risk factors for persistent chronic widespread pain: a community-based study. Rheumatology (Oxford) 2001, 40:95–101.CrossRefGoogle Scholar
  11. 11.
    Macfarlane GJ, Thomas E, Papageorgiou AC, et al.: The natural history of chronic pain in the community: a better prognosis than in the clinic? J Rheumatol 1996, 23:1617–1620.PubMedGoogle Scholar
  12. 12.
    Papageorgiou AC, Silman AJ, Macfarlane GJ: Chronic wide-spread pain in the population: a seven year follow up study. Ann Rheum Dis 2002, 61:1071–1074.PubMedCrossRefGoogle Scholar
  13. 13.
    Macfarlane GJ, McBeth J, Silman AJ: Widespread body pain and mortality: a prospective population-based study. Br Med J 2001, 323:662–665. The study which showed that persons reporting widespread pain were at an increased risk for death and, in particular, cancer death.CrossRefGoogle Scholar
  14. 14.
    McBeth J, Silman AJ, Macfarlane GJ: Association of widespread body pain with an increased risk of cancer and reduced cancer survival: a prospective, population-based study. Arthritis Rheum 2003, 48:1686–1692. This study (using subjects from MacFarlane et al. [13 ] but with addi-tional data collected) showed that subjects with widespread pain had an increased incidence for cancer and subsequent poorer survival.PubMedCrossRefGoogle Scholar
  15. 15.
    Smith BH, Elliott AM, Hannaford PC: Pain and subsequent mortality and cancer among women in the Royal College of General Practitioners Oral Contraception Study. Br J Gen Pract 2003, 53:45–46.PubMedGoogle Scholar
  16. 16.
    Makela M, Heliovaara M: Prevalence of primary fibromyalgia in the Finnish population. BMJ 1991, 303:216 -219.PubMedCrossRefGoogle Scholar
  17. 17.
    Dreyer L, Kendall SA, Falk Winther J, et al.: Increased suicide, liver disease and cerebrovascular disease mortality in a cohort of Danish patients with fibromyalgia followed for 16 years. European League against Rheumatism Annual Conference Berlin. 9th-12th June 2004,Google Scholar
  18. 18.
    Wolfe F, Hawley DJ, Anderson J: The long-term outcomes of fibromyalgia: rates and predictors of mortality in fibromyalgia after 25 years follow-up. Arthritis Rheum 1999, 42:S395. A large follow-up study of patients with fibromyalgia which demonstrated increased mortality and in particular an excess of accidental death.CrossRefGoogle Scholar
  19. 19.
    Bennett RM: Adult growth-hormone deficiency in patients with fibromyalgia. Curr Rheumatol Rep 2002, 4:306–312.PubMedCrossRefGoogle Scholar
  20. 20.
    Renehan AG, Zwahlen M, Minder C, et al.: Insulin-like growth factor (IGF)-I, IGF binding protein-3, and cancer risk: system-atic review and meta-regression analysis. Lancet 2004, 363:1346–1353.PubMedCrossRefGoogle Scholar
  21. 21.
    Busch A, Schachter CL, Peloso PM, Bombardier C: Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev 2002, 3:CD003786.PubMedGoogle Scholar
  22. 22.
    Oguma Y, Sesso HD, Paffenbarger RS Jr, Lee IM: Physical activity and all cause mortality in women: a review of the evidence. Br J Sports Med 2002, 36:162–172.PubMedCrossRefGoogle Scholar

Copyright information

© Current Science Inc 2005

Authors and Affiliations

  • Gary J. Macfarlane
    • 1
  1. 1.Epidemiology GroupUniversity of Aberdeen, Department of Public Health, School of MedicineAberdeenUK

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