Fibromyalgia: Prevalence, epidemiologic profiles and economic costs

Abstract

Fibromyalgia is an idiopathic chronic condition that causes widespread musculoskeletal pain, hyperalgesia and allodynia. This review aims to approach the general epidemiology of fibromyalgia according to the most recent published studies, identifying the general worldwide prevalence of the disease, its basic epidemiological profiles and its economic costs, with specific interest in the Spanish and Comunidad Valenciana cases.

Fibromyalgia affects, on average, 2.10% of the world's population; 2.31% of the European population; 2.40% of the Spanish population; and 3.69% of the population in the Comunidad Valenciana. It supposes a painful loss of the quality of life of the people who suffer it and the economic costs are enormous: in Spain is has been estimated at more than 12,993 million euros annually.

Resumen

La fibromialgia es una enfermedad crónica idiopática que ocasiona dolor musculoesquelético generalizado, hiperalgesia y alodinia. La presente revisión pretende aproximarse a la epidemiología general de la fibromialgia de acuerdo con los más recientes estudios publicados, identificar la prevalencia general de la enfermedad a nivel mundial, sus perfiles epidemiológicos básicos y los costes económicos que ocasiona, con interés específico en el caso de España y de la Comunidad Valenciana.

La fibromialgia afecta como promedio a un 2,10% de la población mundial; al 2,31% de la europea; al 2,40% en la población española y al 3,69% de la población en la Comunidad Autónoma Valenciana. Supone una dolorosa pérdida de la calidad de vida de las personas que la presentan y los costes económicos son enormes: en el caso español se han estimado en más de 12.993 millones de euros anuales.

Introduction

Fibromyalgia (FM) is a chronic condition of unknown aetiology, characterized by the presence of chronic generalized musculoskeletal pain, with low tolerance to pain, hyperalgesia and allodynia. In affected individuals, the presence of chronic pain usually coexists with other symptoms, mainly fatigue, sleep problems, anxiety and depression, but patients may also experience paresthesias, joint stiffness, headache, swelling in the hands, concentration difficulties and memory impairment. The natural course of FM is chronic, with fluctuations in the intensity of symptoms over time. Its etiopathogenesis is not clearly defined. It is considered multifactorial and combines genetic and epigenetic factors that determine a persistent dysfunction in pain regulation systems and central nociceptive hyperexcitability along with a decreased inhibitory response activity related to pain modulation and control.

The risk of suffering FM seems to be controlled by several essential factors: being female (the sex ratio is approximately 9 women per every male); familial aggregation; the concomitant existence of chronic regional pain (myofascial, pelvic, lumbar, headache,…) and the presence of emotional stress (anxiety, depression and, to a lesser extent, post-traumatic stress and obsessive–compulsive disorder).¹ In addition, it is more frequent in the adult age, especially between 40 and 49 years of age; more frequent in rural than in urban areas and is also more common among people with lower educational and economic levels.2, 3