Prevalence and Statistics Concerning Fibromyalgia

One of the most difficult aspects of determining the prevalence and statistics concerning fibromyalgia is the difficulty many patients face in obtaining a diagnosis. Often people have chronic pain, and either fail to discuss this with their doctor, or the physician fails to make a diagnosis of fibromyalgia. Often the syndrome is seen as a symptom of another health issue and therefore is misdiagnosed or left undiagnosed. In some situations, especially in menopausal and post-menopausal women the symptoms may be treated as menopausal issues and not as a separate and unique health condition.

Prevalence

Various organizations and agencies report different possible ranges for the prevalence of fibromyalgia in the general population. In the United States in a study completed in 1995 it was found that 2% of the 3,006 random people interviewed in Wichita, Kansas had fibromyalgia. The female reports were approximately 3.4% of the total surveyed and men accounted for 0.5% of those that had fibromyalgia.  Women tended to have higher reports with both genders reporting fibromyalgia more often as they aged. 1

More recent studies tend to indicate that the prevalence of fibromyalgia is increasing worldwide. In a recent study in five European countries a screening questionnaire had individuals respond to questions about pain and fatigue. In those rheumatology outpatients 46% reported positive for chronic widespread pain and 32% reported for both pain and fatigue. Of these patients there were 14% confirmed diagnoses of fibromyalgia. In the more general population the researchers estimated from the data collected that the prevalence of fibromyalgia was 4.7% and was age and gender related.2

In the United States a study on fibromyalgia and other rheumatic conditions which included gout, carpal tunnel syndrome, osteoarthritis, polymyalgia rheumatic and other conditions including neck and back pain, showed that an estimated 5 million have fibromyalgia with up to 59 million having lower back pain and 30.1 million reporting neck pain within the previous three months of the survey. 3

Other more general approximations indicate that the global estimates for fibromyalgia range between a low of 0.7% to as high as 4.5%. Other organizations, including the National Fibromyalgia Association have the range narrower and higher at between three and six percent of the worldwide population.

Who Gets Fibromyalgia?

Anyone can potentially be at risk for the development of fibromyalgia. It is most common in adults and is also seen at higher rates in individuals that have had traumatic injuries, hormonal variations, are under high and chronic stress, history of depression or other mental health issues and those that have irregular and poor sleep patterns.

Universally the highest rate of fibromyalgia is in women. This ratio is not just a slight increase for women: it is actually 9:1 for women and men. Researchers are not clear why women have higher rates of diagnosis of fibromyalgia but hormonal factors, behavioral differences, environmental issues and the pathways of development and appearance of the symptoms of fibromyalgia may be different between men and women. 4

Fibromyalgia is also more commonly diagnosed in people between the ages of 20 to 50, however those much younger, including children, and those older than 50 can also be diagnosed. Since diagnosis is typically made around the age of menopause for women the actual number of adults that have fibromyalgia rises as the population ages. It is estimated by the American College of Rheumatology that approximately 8% of the population at or over the age of 80 has fibromyalgia.

Children that develop fibromyalgia may have slightly different symptoms than adults but they typically have the pain points and overall sensitivity to touch and pressure. Many medical practitioners do not use the diagnosis of fibromyalgia with children and may instead diagnose complex regional pain syndrome or idiopathic pain and treat the symptoms as opposed to making a fibromyalgia diagnosis. 5

Although there is little evidence to support variations in the number of women and men of different ethnic groups that have fibromyalgia, there is some indication that the condition is most commonly diagnosed in older white women. The research on the development and diagnosis of fibromyalgia in African-Americans, Native Americans, Asians and Hispanics is not significant. This may be due to lack of diagnosis because lower levels of health care and health insurance in these groups simply lowers the chances of diagnosis. However, given the global prevalence of this condition it is hypothesized by many researchers that ethnicity is less of a factor with this syndrome than with many other health conditions.

What has been noted in research is that women that have more emotional and mental health conditions tend to have higher rates of diagnosis of fibromyalgia. They include those with higher self-reporting of negative emotions, such as feelings of depression and anxiety, a higher rate of emotion-avoidance behaviors and higher reports of pain.6 Considering women that report high levels of chronic pain to a rheumatologist or pain specialist may increase the diagnosis levels and provide a more accurate picture of the prevalence of the condition.

Increasing Diagnosis Numbers

As more physicians worldwide become familiar with and gain a better understanding of fibromyalgia it is anticipated that the number of diagnosed cases will increase. This does not mean that the rates of fibromyalgia are truly increasing, simply that more cases are being recognized and treated. Further research into this syndrome is necessary to help identify high risk or target groups that physicians need to focus in on when they present symptoms that are consistent with fibromyalgia.

Physician education as well as a greater awareness within the community, particularly in menopausal women and women with a concurrent diagnosis of depression, chronic fatigue syndrome, restless leg syndrome, migraines and other neurological conditions, will also lead to increasing numbers of patients diagnosed with fibromyalgia.

Research into treatment and causes, and developing consistent diagnostic criteria for the condition is also important to being able to enhance the current understanding of the prevalence of this potentially devastating health condition.

References

1 Wolfe, F., Ross, K., Anderson, J., et al. (1995). The prevalence and characteristics of fibromyalgia in the general population. Arthritis and Rheumatism , 19-28.

2 Branco, J. c., Bannwarth, B., Failde, I., et al. (2008). Prevalence of Fibromyalgia: A Survey in Five European Countries. Seminars in Arthritis and Rheumatism , 448-453

3 Lawrence, R. C., Felson, D. T., Helmick, C. G., et al. (2008). Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part II. Arthritis & Rheumatism , 26-35.

4 Bartels, E., Jacobsen, S., Jesperson, A., et al. (2009). Fibromyalgia, diagnosis and prevalence. Are gender differences explainable? Ugeskr Laeger , 3588-3592.

5 Sherry, D. D. (2005). Fibromyalgia in Children. In D. J. Wallace, & D. J. Clauw, Fibromyalgia and Other Central Pain Syndromes (pp. 177-186). Lippincott Williams & Wilkins.

6 van Middendorp, H., Lumley, M., Jacobs, J. W., et al. (2008). Emotions and emotional approach and avoidance strategies in fibromyalgia. Journal of Psychosomatic Research , 159-167.

This article was originally published on July 11, 2012 and last revision and update of it was 9/7/2015