The impact of COVID-19 pandemic on mental and physical wellbeing in women with fibromyalgia: a longitudinal mixed-methods study

Abstract

Objective The COVID-19 pandemic has strongly influenced psychological and physical health worldwide. The aim of this study was to examine the impact of the pandemic on women with fibromyalgia. Methods This mixed methods pilot study explored measures of pain severity and interference, as well as pain catastrophizing and level of fibromyalgia impact among women with fibromyalgia before and during the COVID-19 pandemic in the USA. Fibromyalgia patients completed demographic, pain-related, and other validated psychosocial questionnaires prior to the onset of the COVID-19 pandemic, and then were re-assessed with those questionnaires, as well as a pandemic-related questionnaire assessing the impact of the pandemic on the patients’ life, during the pandemic. Results When comparing data reported before the pandemic to data collected 3–6 months into the pandemic, women with fibromyalgia reported a general worsening of their pain and pain-related symptoms. During the pandemic, pain catastrophizing (p ≤ 0.05) and fibromyalgia impact (p ≤ 0.05) increased significantly compared to before the pandemic. The increase in pain catastrophizing scores was highly correlated with the impact of the pandemic on the participants’ ability to cope with pain and on their mental health. Qualitative analysis corroborated the significant impact of the pandemic on patients’ mental health, with the vast majority reporting a worsening of their mood. Other impacted domains included anxiety, level of activity and sleep. Conclusions Collectively, the pandemic appears to have produced a substantive worsening of pain-related symptomatology among women with fibromyalgia, which should be addressed by targeted interventions.

Has the COVID 19 Pandemic Impacted the Management of Chronic Musculoskeletal Pain?

“…These findings are consistent with a prior review, which emphasized the impact of social isolation due to the COVID-19 pandemic on physical and mental health in geriatric chronic musculoskeletal pain patients, with loneliness correlated to worsened debility and pain interference [ 22 •]. Although none of the papers in this review looked explicitly at loneliness, we consistently found the influence of decreased mood on the perception of pain, with higher pain catastrophizing [ 8 , 37 , 44 ], pandemic-related fear and stress [ 33 , 35 , 43 ], and anxiety and depression [ 47 , 50 ], all associated with increased levels of pain. With a broader review of published literature and significantly more patient-reported outcomes, our review further emphasizes the role psychological health played in the wellbeing of chronic musculoskeletal pain patients during the COVID-19 pandemic.…”

“…The sample size ranged from 38 to 965; 86–100% of patients were female. The rate of COVID-19 positive tests was 5–7% in two studies [ 33 , 37 ]. Two other studies excluded patients with a history of COVID-19 infection [ 35 , 39 ].…”

“…Of the seven studies, four reported that fibromyalgia patients experienced increased pain and worsened mental health during the COVID-19 pandemic [ 33 – 35 , 37 ]. During the lockdown, increased pain and worsened mental health correlated to higher pain catastrophizing scores [ 37 ] and lower levels of social support and optimism [ 34 ]. In a study from Turkey, pandemic-related psychological stress had a greater impact on fibromyalgia patients compared to healthy controls, negatively affecting symptom severity, sleep quality, and mood [ 35 ].…”

“…Similarly, decreased physical activity associated with social isolation negatively affected pain levels and physical function, particularly in chronic LBP patients. Importantly, we found a concurrent worsening of psychological and physical symptoms in chronic musculoskeletal pain patients, with the severe impact of the COVID-19 pandemic on patients’ mental health likely contributing to worsened physical symptoms [ 8 , 32 – 35 , 37 , 43 , 44 , 47 , 50 ]. Of note, positive coping strategies, including consistent physical activity, social support, refocusing, and positive reappraisal correlated with no change or improved outcomes, especially in fibromyalgia patients.…”

Whole-Body Photobiomodulation Therapy for Fibromyalgia: A Feasibility Trial

“…Further research is needed around this for people with FM. With regards to sleep, a recent Cochrane review suggests a JSQ MCID value of 20% [74] – a value which 100% of the study population achieved, with some improvements as high as 90%. Localised PBMT meta-analyses have not explicitly reported on sleep [134].…”