Is Fibromyalgia New Startling Global Epidemic?
If you have been unfortunate enough to suffer with fibromyalgia condition then you would have often wondered that is that only you who suffer from this miserable illness.
The truth is, there is a lot of contradictory and even outright false information about the severity of fibromyalgia epidemic across the globe.
Consider these key stats:
- Fibromyalgia syndromes (FMS) affects 2% of worldwide population
- It is more common in women than in men, with a gender ration of 7:1
- On average, it takes 1.9 to 2.7 years and 2 to 4 physicians to receive accurate diagnosis.
- FMS patients physical function and quality of life are often reduced.
- Medical cost is high, up to 10 years before diagnosis and constructive diagnosis can reduce healthcare cost.
I can not tell you the number of times I have seen people wondering among themselves that whether it is only them who have this painful condition.
Let us start briefly about the history of fibromyalgia and how this chronic painful condition is affecting world wide population than we actually realize it.
Brief History of Fibromyalgia Syndrome.
Fibromyalgia was first identified in mid-1800. In 1850, It was reported that several rheumatism patients had hard places in muscles, which were painful when pressed.
In 1904 the term ‘fibrositis’ was introduced which was described as regional pain syndrome, including sensitivity to light touch, fatigue and sleep disturbance in the absence of any signs of local or systemic inflammation.
In 1970, it was identified that fibromyalgia patients have certain locations which are more sensitive and tender than non-fibromyalgia patients.
It was also found that fibromyalgia patients had stage 4 sleep disturbance which leads to myalgia, fatigue, and muscle tenderness.
There had been renewed interest in studying fibromyalgia in the 1980s, and several studies were conducted to know more about the fibromyalgia condition and its symptoms.
It was during this period the current diagnostic process to identify fibromyalgia was developed.
Moreover, the primary and secondary fibromyalgia symptoms were developed based on the occurrence of fibromyalgia symptoms with the chronic painful rheumatic disease.
In 1990, the American College of Rheumatology (ACR) published the criteria to identify the fibromyalgia symptoms.
Several fibromyalgia patients were studied, and a combination of widespread pain, above and below the waist, and at least 11 of 18 specified tender points were identified to be standard diagnostic criteria to determine the symptoms in fibromyalgia patients.
These tests were not designed to be diagnostic criteria, but they are now widely used as such in routine clinical practice.
Who Gets Affected By Fibromyalgia?
It is estimated that the prevalence of fibromyalgia symptoms in the general population ranges from 0.5% to 4%.
The prevalence of fibromyalgia symptoms in medical outpatients’ clinics is much higher than it the general population and ranges from 10% to 16% in rheumatology outpatient clinics.
Factors which affects the probability of getting fibromyalgia.
- Gender: Women have 3-7 times more chance to suffer from fibromyalgia than men.
- Age: Fibromyalgia symptoms may be diagnosed in individuals of all ages. Symptoms usually arise in those aged 20-55 years, but the condition may also occur in childhood.
- Ethnicity: Researchers have not identified any correlation with developing fibromyalgia to the ethnicity. Fibromyalgia has been found in all ethnic groups and cultures.
- Risk Factors: There are no one single cause to get fibromyalgia. It is believed to be caused by the problem with the central nervous system and are commonly triggered due to various factors.
- Genetics: There have been some studies which show that genetic play a significant role in the development of fibromyalgia symptoms. Studies have identified the presence of certain genes can cause the higher chance of developing fibromyalgia symptoms.
Several studies have shown that psychological condition, such as stress, anxiety, major depression, panic disorder, and familial primary mood disorder, are the risk factors for developing FMS.
Twenty-eight percent of children from fibromyalgia mother were found to suffer from widespread chronic pain.
Other factors such as previous trauma and sociocultural factors such as low income, being divorced, being disabled, smoking, lower social class and less education have all been found to be relevant, but no direct evidence has been found to relate it to developing fibromyalgia symptoms.
Percentage of people in United States suffering with Fibromyalgia
Comparison with Europe and the United States did not identify any significant difference.
Poor Quality of Life in Fibromyalgia Patients
Fibromyalgia patients have a varying degree of pain severity which impacts their quality of life. Approximately 50% of fibromyalgia patients have difficulty with routine daily activities, while 30-40% have to stop work or change their employment.
On average, fibromyalgia patients experience 6 to 11 symptoms including widespread chronic pain, sleep disturbance, fatigue and touch sensitivity.
On a scale of 1-10 (0=lowest and 10= highest), the average “present quality of life’ score for fibromyalgia patients was 4.8.
The most affected areas are physical mobility, change in mood, depression, problem concentration and memory, and lack of motivation and drive.
Physical Discomfort in Fibromyalgia Patients
Fibromyalgia patients often find it difficult to perform daily activities. Many patients complain of stiffness in the morning and need some time to feel better and get back into daily activities.
The cold weather often aggravates the pain and tasks which require sustained or repetitive physical effort found to be difficult to perform.
Fibromyalgia patients have significantly lower physical and mental health scores than patients with a similar painful condition such as rheumatoid arthritis.
Psychological Stress and Mental Health Condition
Fibromyalgia patients usually suffer from higher psychological stress and poor mental health condition. Fibromyalgia patients have significantly higher Nottingham Health Profile score, indicating a lower general health status.
Fibromyalgia patients are often depressed and lack the ability to concentrate on a highly focused task. Patients with depression tend to have higher Nottingham Health Profile scores which suggest a significant relationship between pain, depression, and overall quality of life.
Moreover, the Nottingham Health Profile score correlate with disease duration, suggesting that chronicity may also adversely impact general health and quality of life.
Sleep disturbance, frequent in fibromyalgia patients, increases the pain, fatigue, and mental health condition which turn out to be another aggravating factor.
Controlling the psychological stress through meditation, yoga, and interventions designed to improve sleep quality may help to restore the health-related quality of life in Fibromyalgia patients.
Other risks of negative behaviours due to the severity of pain, poor emotional health may lead to excessive self-medication and overuse of sleeping pills, alcohol, drugs, or caffeine.
A study in 2001 found a higher incidence of self-induced harm such as suicide, and accidents among people with widespread chronic pain.
Financial Burden of Fibromyalgia Syndrome
The direct financial burden of fibromyalgia illness is immense.
As per 2012 study, more than 100 million people in North America suffer from chronic pain condition with an annual price tag of more than 65 billion dollars.
On top of that, 35% of fibromyalgia patients spend between $100-$1,000 per months above their insurance to see a healthcare profession. Indirect cost related to the loss of productivity and missed work estimated to be $12-$14 billion each year.
The average fibromyalgia patient makes ten primary care appointments per year and is hospitalized, once every three years.
The resource utilization by fibromyalgia patients are similar to other chronic disease patients, but the fibromyalgia patients receive less attention from the healthcare system.
Approximately one-third of fibromyalgia patients have to adapt their work, shorten their workdays and take regular time off from work. It causes the decreased income and increased financial burden in the fibromyalgia patients.
Although the direct cost of fibromyalgia illness is staggering and somewhat easy to identify the indirect cost such as personal and emotional cost to patients, their families, and friend is tremendous and difficult to put a price tag.
Long Diagnosis Period to Determine Fibromyalgia
Fibromyalgia symptoms tend to overlap with several other medical conditions such as arthritis, sleep apnea, migraine, etc. which often causes either misdiagnosis or long series of testing to eliminate the cause of other symptoms.
In a survey, the fibromyalgia patients waited on average from 5 months (UK) to 1.5 years (Mexico) to consult a physician. After consultation, these patients took another 2 to 3 years and between 2 to 4 doctors to receive an accurate diagnosis.
This longer diagnosis period effectively understates the number of fibromyalgia patients globally affected by this chronic condition.
Physician Attitude toward Fibromyalgia
Despite the several current pieces of research, many physicians stated that they found fibromyalgia somewhat tough to diagnose. The other contributing factor in difficulty diagnosing fibromyalgia is due to the difficulty in fibromyalgia patients to communicate their symptoms.
The percentage of physicians who reported confidence in recognizing fibromyalgia symptoms and differentiating with other similar symptoms varied across the physicians.
Rheumatologist found to be more confident than the other expert in recognizing and differentiating fibromyalgia symptoms with other conditions.
Is Fibromyalgia Silent Global Epidemic?
As we now know that the Fibromyalgia is a global worldwide phenomenon and often misunderstood disease.
As per studies worldwide, the fibromyalgia is found to affect 3-6% of world population with women to be more affected than men.
Considering the world population to be 7 Billion that turn out to be close to 200 million to 400 million people suffering from this chronic painful condition.
In North America alone close to 10 million people are found to suffer from fibromyalgia condition.
Fibromyalgia is also more prevalent in people over 50 years of age, in subjects with low education level, with low socioeconomic status, living in rural areas, and possibly in obese women.
As per world bank data, in 2015 approximately 45% of the global population live in the countryside with a higher degree of the rural population in developing countries where there is often a lack of medical facility and treatment.
It shows that the number of fibromyalgia patients is grossly under-represented.
External environment factors such as increase in the pollution, toxicity in the foods due to a use of pesticides and lifestyle changes such as increase in the stress, decrease in the physical activities are causing the fibromyalgia symptoms to be triggered frequently.
One possible reason that fibromyalgia is not getting enough attention than other diseases is that fibromyalgia is not a life threatening condition unlike HIV, Cancer or even heart disease.
But there is no doubt that fibromyalgia condition significantly reduces the quality of life and the direct and indirect financial cost is staggering to not only the patient but also to the nation.
It is important to have more research and nation-wide epidemiological studies on fibromyalgia to have a better view of the prevalence of this disorder worldwide and to measure the burden of Fibromyalgia condition on persons, families, and society.
You can share your fibromyalgia experience in the comment below.
You can also join the discussion at the Fibromyalgia Pain Cure Facebook page which is dedicated to a discussion of natural treatments for fibromyalgia and other chronic pain conditions.
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