Risk Factors for Fibromyalgia

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Risk Factor Source
middle age White 2001
female Tan 2019
transgender Levit 2021
Abuse or neglect in your childhood
sexual abuse Walker 1997, Sigurdardottir 2013, Alexander 1998, Imbierowicz 2003
physical abuse Walker 1997, Imbierowicz 2003, Olivieri 2012, Alexander 1998
parent who was alcoholic Goldberg 1999, Imbierowicz 2003
parent was addicted Goldberg 1999, Imbierowicz 2003
raised by depressed parent age 0-18 Olivieri 2012
mother was addicted Imbierowicz, 2003
severe neglect in childhood by your parents
raised by a depressed person mother
childhood victimization Walker 1997, Goldberg 1999
emotional abuse Walker 1997
adult victimization Walker 1997
verbal abuse by parents (insulted or cursed) Olivieri 2012
adverse childhood experiences Fay 2015
poor emotional relationship with both parents during childhood Imbierowicz 2003
experiences of the parents’ physical quarrels Imbierowicz 2003
a lack of physical affection in childhood Imbierowicz 2003
a poor financial situation before the age of 7 Imbierowicz 2003
separation Imbierowicz 2003
Stressful or traumatic events, such as car accidents https://www.cdc.gov/arthritis/basics/fibromyalgia.htm
post-traumatic stress disorder (PTSD) https://www.cdc.gov/arthritis/basics/fibromyalgia.htm
trauma Hauser 2015
Prior history of certain rheumatologic (joint diseases)
rheumatoid arthritis Pardo 2019
SLE Staud, 2006
Prior history of other diseases
IBD Pardo 2019
endometriosis Pardo 2019
Family history
Family history of fibromyalgia Offenbaecher, 1998
Separation during one’ s childhood Imbierowicz, 2003
Headaches and other pain
Headaches Creed 2020 (strong association)
Primary pain disorders Cited in Tan, 2019
Lifestyle factors (prior to FM)
smoking Sommer 2012
low income, social level or socio-economic status
grew up in poverty before age 7 (certain populations) Imbierowicz 2003
divorced Olivieri et al. 2012
disabled White 1999
lower household income White 1999
lower education White 1999
lack of emotional support Olivieri 2012
not married Olivieri 2012
low socio-economic status White 1999, Shochat 2003
after a mass disaster or mass scare (epidemic fibromyalgia, e.g. as in Chernobyl) Pastel 2002
depression Offenbaecher 1998, Beck 2000
anxiety secondary to depression Beck 2000
bipolar Beck 2000
sleep disorders (strong association) Creed 2020, Mork 2012
sleep apnea Rosenfeld 2015, Mutlu 2020
Gynecological/ Female reproductive
endometriosis Pardo 2019
late menarche (after age 14) Shochat 2003
premenopausal women with climacteric symptoms Carranza-Lira 2019
never pregnant Schochat 2003, NFA survey
Early menopause Pamuk 2009
physical Haviland 2010
sexual Haviland 2010
rape/ forced sex Ciccone 2015, Olivieri 2012
repetitive injuries. Injury from repetitive stress on a joint, such as frequent knee bending Gallinaro 2001
verbal abuse by parents (insulted or cursed) Olivieri 2012
adverse childhood experiences Fay 2015
poor emotional relationship with both parents during childhood Imbierowicz 2003
experiences of the parents’ physical quarrels Imbierowicz 2003
a lack of physical affection in childhood Imbierowicz 2003
a poor financial situation before the age of 7 Imbierowicz 2003
separation Imbierowicz 2003
osteomyelitis Chen 2017
HIV Dotan, 2016
prior hysterectomies Vincent 2011
high body mass index Creed 2020
obesity Sommer 2012
physical inactivity Sommer 2012
less than high school education White 1999
Genetic polymorphisms
COMT Finan 2011, Martinez-Jauand 2013
serotonin transporter gene regulatory (SLC6A4) Arnold 2013
monoamine oxidase (MAO-A) Knezevic 2018
dopamine receptor D4 (DRD4) Knezevic 2018
β-2 adrenergic receptor Knezevic 2018
guanosine triphosphate cyclohydrolase (GTPCH) (involved in the dopamine, serotonin, and nitric oxide production) Knezevic 2018
γ-aminobutyric acid (GABA) Knezevic 2018
a receptor β3 subunit (GABRB3) Knezevic 2018
sodium channel NaV1.7 (SCN9A) Knezevic 2018
apolipoprotein (APOE) Knezevic 2018
myelin transcription factor 1-like (MYT1L) (involved in neuronal differentiation) Knezevic 2018
neurexin (NRXN3), a synaptic scaffolding stabilizer in glutamate and GABA neurotransmission Knezevic 2018
ACEI/D polymorphism Inanir 2015
transient receptor potential vanilloid 2 genes (TRPV2) Arnold 2013
Strongly suspected risk factors
PTSD Hauser 2013
strained (stressful) immigration in new immigrant struggling to adjust Anecdotal
a parent was a chronic pain patient while you were growing up Higgins 2016
war refugees Gammoh 2020, Al-Smadi 2021
premature birth Multiple sources cited in Low 2012
obesity Ursini 2011
Military service in women (with or without combat) D'Aoust 2017, anecdotal evidence from frontline doctor working at a veteran’s affairs hospital, history of shell shock and neurasthenia in WWII, and known role of trauma in FM

References in alphabetical order by lead author[edit]

Sexual and physical abuse in women with fibromyalgia: association with outpatient health care utilization and pain medication usage. Alexander RW1, Bradley LA, Alarcón GS, Triana-Alexander M, Aaron LA, Alberts KR, Martin MY, Stewart KE. Arthritis Care Res. 1998 Apr;11(2):102-15.)

Psychiatric Disorders and Functional Disability in Patients with Fibromyalgia, Arne Beck, George Breth, Rob Hays; Colleen Miller, Permanente Journal, Summer 2000, Vol, 4 No. 3, https://www.thepermanentejournal.org/files/Summer2000/fibro.pdf.

The fibromyalgia family study: a genome-wide linkage scan study. Arnold LM, Fan J, Russell IJ, Yunus MB, Khan MA, Kushner I, Olson JM, Iyengar SK Arthritis Rheum. 2013 Apr; 65(4):1122-8.

Relationship between anxiety, post-traumatic stress, insomnia and fibromyalgia among female refugees in jordan: A cross-sectional study. Al-Smadi AM, Tawalbeh LI, Gammoh OS, Ashour AF, Shajrawi A, Attarian H. J Psychiatr Ment Health Nurs. 2021 Aug;28(4):738-747. doi: 10.1111/jpm.12732. Epub 2021 Jan 25.

Prevalence of fibromyalgia in premenopausal and postmenopausal women and its relation to climacteric symptoms. Sebastián Carranza-Lira and Idun Berenice Villalobos Hernandez, Prz Menopauzalny. 2014 Jun; 13(3): 169–173, available in full online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4520359/

Increased Risk of New-Onset Fibromyalgia Among Chronic Osteomyelitis Patients: Evidence From a Taiwan Cohort Study, Jiunn-Horng Chen, Chih-Hsin Muo, Chia-Hung Kao, Chon-Haw Tsai, Chun-Hung Tseng J Pain. 2017 Feb;18(2):222-227. doi: 10.1016/j.jpain.2016.11.002. Epub 2016 Nov 22, DOI: 10.1016/j.jpain.2016.11.002

A review of the incidence and risk factors for fibromyalgia and chronic widespread pain in population-based studies. Francis Creed Pain. 2020 Jun;161(6):1169-1176.DOI: 10.1097/j.pain.0000000000001819. Mil Med. 2017 Jul;182(7):e1828-e1835, doi: 10.7205/MILMED-D-15-00557.

Women Veterans, a Population at Risk for Fibromyalgia: The Associations Between Fibromyalgia, Symptoms, and Quality of Life, Rita F D'Aoust 1, Alicia Gill Rossiter 1, Amanda Elliott 1, Ming Ji 1, Cecile Lengacher 1, Maureen Groer 1 OI: 10.7205/MILMED-D-15-00557

Prevalence and characteristics of fibromyalgia among HIV-positive patients in southern Israel, Idit Dotan 1, Klaris Riesenberg 2, Ronen Toledano 2, Francisc Schlaeffer 2, Alexander Smolyakov 2, Lisa Saidel-Odes 2, Oded Wechsberg 1, Jacob N Ablin 3, Victor Novack 1, Dan Buskila 1 Clin Exp Rheumatol. Mar-Apr 2016;34(2 Suppl 96):S34-9, Epub 2016 Mar 3.

COMT Moderates the Relation of Daily Maladaptive Coping and Pain in Fibromyalgia, Patrick H. Finan,1 Alex J. Zautra,1 Mary C. Davis,1 Kathryn Lemery-Chalfant,1Jonathan Covault,2 and Howard Tennen, Pain. 2011 Feb; 152(2): 300–307.available in full online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3053137/.

An evaluation of the association between fibromyalgia and repetitive strain injuries in metalworkers of an industry in Guarulhos, Brazil, A L Gallinaro 1, D Feldman, J Natour, Joint Bone Spine, 2001 Feb;68(1):59-64, DOI: 10.1016/s1297-319x(00)00226-8, https://pubmed.ncbi.nlm.nih.gov/11235782/.

Syrian female war refugees: preliminary fibromyalgia and insomnia screening and treatment trends. Gammoh OS, Al-Smadi A, Tayfur M, Al-Omari M, Al-Katib W, Zein S, Attarian H. Int J Psychiatry Clin Pract. 2020 Nov;24(4):387-391. doi: 10.1080/13651501.2020.1776329. Epub 2020 Jul 13.

Relationship between traumatic events in childhood and chronic pain. Goldberg RT1, Pachas WN, Keith D. Disabil Rehabil. 1999 Jan;21(1):23-30, abstract available online at: https://www.ncbi.nlm.nih.gov/pubmed/10070600)

Self-reported childhood maltreatment, lifelong traumatic events and mental disorders in fibromyalgia syndrome: a comparison of US and German outpatients. Häuser W1, Hoffmann EM2, Wolfe F3, Worthing AB4, Stahl N5, Rothenberg R6, Walitt B7. Clin Exp Rheumatol. 2015 Jan-Feb;33 (1 Suppl 88):S86-92. Epub 2015 Mar 18, available in full online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750383/.)

Traumatic experiences, major life stressors, and self-reporting a physician-given fibromyalgia diagnosis. Mark G. Haviland,a,*,1 Kelly R. Morton,b Keiji Oda,c and Gary E. Fraserd, Psychiatry Res. 2010 May 30; 177(3): 335–341, doi: 10.1016/j.psychres.2009.08.017, available in full online at: Traumatic experiences, major life stressors, and self-reporting a physician-given fibromyalgia diagnosis (nih.gov)

Posttraumatic stress disorder in fibromyalgia syndrome: prevalence, temporal relationship between posttraumatic stress and fibromyalgia symptoms, and impact on clinical outcome, Winfried Häuser 1, Alexandra Galek, Brigitte Erbslöh-Möller, Volker Köllner, Hedi Kühn-Becker, Jost Langhorst, Franz Petermann, Ulrich Prothmann, Andreas Winkelmann, Gabriele Schmutzer, Elmar Brähler, Heide Glaesmer Pain. 2013 Aug;154(8):1216-23, doi: 10.1016/j.pain2013.03.034. Epub 2013 Apr 2.

Offspring of Parents with Chronic Pain: A Systematic Review and Meta-Analysis of Pain, Health, Psychological, and Family Outcomes. Kristen S. Higgins,1,2 Kathryn A. Birnie,1,2 Christine T. Chambers,1,2 Anna C. Wilson,3 Line Caes,4 Alexander J. Clark,1,5 Mary Lynch,1,5 Jennifer Stinson,6,7 and Marsha Campbell-Yeo1,2 Pain. 2015 Nov; 156(11): 2256–2266, doi: 10.1097/j.pain.0000000000000293

Childhood adversities in patients with fibromyalgia and somatoform pain disorder, Katrin Imbierowicz, Ulrich T Egle, February 2003 European journal of pain (London, England) 7(2):113-9. DOI:10.1016/S1090-3801(02)00072-1, https://www.researchgate.net/publication/10887542_Childhood_adversities_in_patients_with_fibromyalgia_and_somatoform_pain_disorder

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Early Life Adversity as a Risk Factor for Fibromyalgia in Later Life, Lucie A. Low and Petra Schweinhardt* Pain Res Treat. 2012; 2012: 140832, available in full online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3196867/

Martinez-Jauand M., Sitges C., Rodriguez V., Picornell A., Ramon M., Buskila D., Montoya P. Pain sensitivity in fibromyalgia is associated with catechol-O-methyltransferase (COMT) gene. Eur. J. Pain. 2013;17:16–27. doi: 10.1002/j.1532-2149.2012.00153.x. [PubMed] [CrossRef] [Google Scholar]

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Prevalence of obstructive sleep apnea in female patients with fibromyalgia, Pinar Mutlu, MD, Çoşkun Zateri, MD, Ali Zöhra, MD, Özgür Özerdoğan, MD, and Arzu N. Mirici, MD Saudi Med J. 2020 Jul; 41(7): 740–745, doi: 10.15537/smj.2020.7.25165, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7502927/.

Possible association of fibromyalgia with a polymorphism in the serotonin transporter gene regulatory region. Offenbaecher M, Bondy B, De Jonge S, Glatzeder K, Kruger M, Schoeps P, Ackenheil M. Arthritis Rheum. 1999;42(11):2482–2488. [PubMed]

Childhood risk factors for developing fibromyalgia. Patrick Olivieri,1 Bruce Solitar,2,* and Michel Dubois3,* Open Access Rheumatol. 2012; 4: 109–114, 2012 Dec 17. doi: 10.2147/OARRR.S36086. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. available in full online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5045103/.

Increased frequencies of hysterectomy and early menopause in fibromyalgia patients: a comparative study. Pamuk ON, Dönmez S, Cakir N. Clin Rheumatol. 2009 May;28(5):561-4. doi: 10.1007/s10067-009-1087-1. Epub 2009 Jan 24. PMID: 19169621

A diagnosis of rheumatoid arthritis, endometriosis or IBD is associated with later onset of fibromyalgia and chronic widespread pain. Fabian Larrosa Pardo 1 2, Elisabeth Bondesson 1 3, Maria E C Schelin 2 4, Anna Jöud. Eur J Pain 2019 Sep;23(8):1563-1573 Epub 2019 Jun 17, DOI: 10.1002/ejp.1432

Radiophobia: long-term psychological consequences of Chernobyl. Pastel RH. Mil Med 2002 Feb;167(2 Suppl):134-6, https://www.ncbi.nlm.nih.gov/pubmed/11873498 .

[Sociodemographic characteristics, risk factors and reproductive history in subjects with fibromyalgia--results of a population-based case-control study] [Article in German] T Schochat 1, C Beckmann, Z. Rheumatol. 2003 Feb;62(1):46-59. doi: 10.1007/s00393-003-0447-5, https://pubmed.ncbi.nlm.nih.gov/12624804/.

[Etiology and pathophysiology of fibromyalgia syndrome]. [Article in German] Sommer C1, Häuser W, Burgmer M, Engelhardt R, Gerhold K, Petzke F, Schmidt-Wilcke T, Späth M, Tölle T, Uçeyler N, Wang H, Winkelmann A, Thieme K; Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften. Schmerz. 2012 Jun;26(3):259-67.

Chronic Widespread Pain and Fibromyalgia Syndrome: Life-Course Risk Markers in Young People. Aidan C. Tan, 1 Tiina Jaaniste, 2 , 3 and David Champion. Pain Res Manag. 2019; 2019: 6584753, doi: 10.1155/2019/6584753, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525804/.

Fibromyalgia and obesity: the hidden link. Francesco Ursini 1, Saverio Naty, Rosa Daniela Grembiale Rheumatol Int. 2011 Nov;31(11):1403-8, Epub 2011 Apr 8, DOI: 10.1007/s00296-011-1885-z

Pain and other symptom severity in women with fibromyalgia and a previous hysterectomy. Vincent A, Whipple MO, Luedtke CA, Oh TH, Sood R, Smith RL, Jatoi A. J Pain Res. 2011;4:325-9. doi: 10.2147/JPR.S25490. Epub 2011 Oct 7.PMID: 22003306 Free PMC article.

Making Sense of Fibromyalgia: New and Updated, Second edition, Daniel J. Wallace MD, ‎Janice Brock Wallace MPA, available from Google Books in preview mode at: https://books.google.ca/books?id=vz-eAgAAQBAJ&printsec=frontcover#v=onepage&q&f=false. Oxford University Press, 2014.

Psychosocial factors in fibromyalgia compared with rheumatoid arthritis: II. Sexual, physical, and emotional abuse and neglect, E. A. Walker, D. Keegan, G. Gardner, M. Sullivan, D. Bernstein, and W. J. Katon, Psychosomatic Medicine, vol. 59, no. 6, pp. 572–577, 1997. http://citeseerx.ist.psu.edu/viewdoc/download?doi=

The London Fibromyalgia Epidemiology Study (LFES): The Prevalence and Direct Health Care Costs of fibromyalgia syndrome (FMS), in London, Ontario, Kevin P. White, Mark Speechley, Manfred Harth, Truls Ostbye, J Rheumatol. 1999 Jul;26(7):1570-6.