Pain, Emotion, and Functional Limits in Fibromyalgia
Fibromyalgia (FM) is a musculoskeletal chronic pain disorder of unknown pathophysiology that mainly affects women. It is characterized by widespread pain, sleep disturbances, fatigue, tenderness, cognitive difficulties, and other somatic complaints. Despite pain being the characteristic symptom in an FM diagnosis, its high rate of comorbidities has resulted in new diagnosis criteria by the American College of Rheumatology (ACR; Wolfe, Clauw, & Fitzcharles, 2010), which introduces the associated symptomatology as an additional criterion for the diagnosis. Therefore, it is not surprising that many authors have looked into the relationships between pain and associated comorbidities, such as functional limitations, anxiety, and depression.
Accordingly, patients consider that the widespread pain and intense fatigue they feel are responsible for their limitations or the disabilities they suffer in their daily lives (Rivera, 2012). Häuser, Brahler, Wolfe, and Henningsen (2014)) pointed out that pain intensity is associated to perceived disability, and Markkula et al. (2011)), in a 14-year follow-up study, revealed that symptoms associated with FM, including pain, strongly correlate with early retirement due to disability.
The association between pain, anxiety, and depression has been extensively explored in previous literature on chronic pain, establishing a bidirectional relationship that explains the vicious circles of pain–anxiety/depression (Woo, 2012). In the case of FM, its unknown etiology and the possible existence of psychiatric etiologies make the relationship between pain–anxiety/depression controversial (Spaeth, 2013). Nevertheless, when Fishbain, Cutler, Rosomoff, and Rosomoff (1997)) conducted a review of 191 studies, they found that anxiety and depression should be understood as a consequence, not as a cause of chronic pain.
Background
Fibromyalgia, Pain, Functional Limitation, Anxiety, and Depression
Fibromyalgia (FM) is a musculoskeletal chronic pain disorder of unknown pathophysiology that mainly affects women. It is characterized by widespread pain, sleep disturbances, fatigue, tenderness, cognitive difficulties, and other somatic complaints. Despite pain being the characteristic symptom in an FM diagnosis, its high rate of comorbidities has resulted in new diagnosis criteria by the American College of Rheumatology (ACR; Wolfe, Clauw, & Fitzcharles, 2010), which introduces the associated symptomatology as an additional criterion for the diagnosis. Therefore, it is not surprising that many authors have looked into the relationships between pain and associated comorbidities, such as functional limitations, anxiety, and depression.
Accordingly, patients consider that the widespread pain and intense fatigue they feel are responsible for their limitations or the disabilities they suffer in their daily lives (Rivera, 2012). Häuser, Brahler, Wolfe, and Henningsen (2014)) pointed out that pain intensity is associated to perceived disability, and Markkula et al. (2011)), in a 14-year follow-up study, revealed that symptoms associated with FM, including pain, strongly correlate with early retirement due to disability.
The association between pain, anxiety, and depression has been extensively explored in previous literature on chronic pain, establishing a bidirectional relationship that explains the vicious circles of pain–anxiety/depression (Woo, 2012). In the case of FM, its unknown etiology and the possible existence of psychiatric etiologies make the relationship between pain–anxiety/depression controversial (Spaeth, 2013). Nevertheless, when Fishbain, Cutler, Rosomoff, and Rosomoff (1997)) conducted a review of 191 studies, they found that anxiety and depression should be understood as a consequence, not as a cause of chronic pain.