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When Physical Trauma and Infection Trigger Fibromyalgia.

Physical Trauma and Infection as Precipitating Factors in Patients with Fibromyalgia.


OBJECTIVE: The objective of this study was to evaluate both precipitating factors in patients with fibromyalgia and any differences in clinical presentation, symptom severity, and quality-of-life between those with and without precipitating physical trauma or infection.

DESIGN: In a retrospective cross-sectional study, the authors compared patient characteristics and fibromyalgia symptom severity and quality-of-life with the Fibromyalgia Impact Questionnaire and the Short Form-36 Health Survey in patients seen in a fibromyalgia treatment program.

RESULTS: Of 939 patients, 27% reported precipitating factors (trauma, n = 203; infection, n = 53), with the rest having idiopathic fibromyalgia (n = 683). Patients with precipitating trauma were more likely to have worse Fibromyalgia Impact Questionnaire physical function than patients with idiopathic onset (P = 0.03). Compared with patients with idiopathic onset and precipitating trauma, patients with precipitating infection were more likely to have worse Short Form-36 Health Survey physical component summary (P = 0.01 and P = 0.003) but better role emotional (P = 0.04 and P = 0.005), mental health index (P = 0.02 and P = 0.007), and mental component summary (P = 0.03 and P = 0.004), respectively.

CONCLUSIONS: One-fourth of this study's patients with fibromyalgia had precipitating physical trauma or infection. Patients with precipitating infection had different sociodemographic characteristics, clinical presentation, and quality-of-life from the idiopathic and trauma groups. Further studies are needed to look into the relationships between precipitating events and fibromyalgia.

Source: American Journal of Physical Medicine and Rehabilitation [1], April 16, 2015. By Jiao, Juan MD; Vincent, Ann MD; Cha, Stephen S. MS; Luedtke, Connie A. RN; Kim, Chul H. MD; Oh, Terry H. MD. From the Department of Physical Medicine and Rehabilitation (JJ, CHK, THO), Division of General Internal Medicine (AV), Fibromyalgia and Chronic Fatigue Clinic (AV, CAL, THO), and Division of Biomedical Statistics and Informatics (SSC), Mayo Clinic, Rochester, Minnesota; and Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea (CHK). Dr Jiao is now with the Department of Rheumatology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.