A newly published study from doctors at Boston’s Brigham’s and Women’s Hospital has identified a possible relationship between fibromyalgia (FM) and rheumatoid arthritis (RA). The study suggests that an increase in the number of fibromyalgia symptoms in those with rheumatoid arthritis may be a predictor of declining functionality. As a result, those with both RA and FM are likely to experience greater pain, incur higher medical costs, and face a worse quality of life than those who have only one of these conditions.
Rheumatoid arthritis is a form of arthritis that causes inflammation, pain, and swelling in the joints, usually the hands and wrists. However, it can affect any joint and may also cause damage to different body systems including the heart, lungs, eyes, and others. There is no known cure.
Fibromyalgia is a condition marked by non-specific musculoskeletal pain that may also be accompanied by fatigue and sleeplessness, mood swings, and problems with memory. It is often treated effectively using SNRIs medications such as Savella.
Methodology
Researchers analyzed data from individuals with RA participating in the Brigham Rheumatoid Arthritis Sequential Study who had also enrolled in an ancillary study of the effects of pain on FM. They underwent annual testing and physical examinations and filled out questionnaires twice a year.
Key information was pulled from the Polysymptomatic Distress (PSD) Scale, which was used to measure the symptoms and status of their condition, and the Multi-Dimensional Health Assessment Questionnaire (MDHAQ), which assessed pain and physical functioning.
Study Results
Among those enrolled, slightly more than 16 percent had fibromyalgia in combination with their rheumatoid arthritis; the others did not have fibromyalgia. Over a two-year period, as measured by the MDHAQ, those with both RA and FM had an increase in pain along with a decrease in physical functionality. In addition, corticosteroid use was greater among those with both conditions.
The study also examined the psychological impact of both conditions using the Hospital Anxiety and Depression Scale (HADS). This data found no correlation between socio-psychological factors and changes in functional status.
The results of the research have been questioned in some quarters, with some opponents noting, in particular, the limited sample size.
The researchers suggest that including the PSD scale in diagnostic procedures for RA may identify those facing an increased decline in functionality in order to initiate a more overarching program of physical and occupational therapy, and a mix of medication and nonmedication-based treatment modalities.
