Headache, Migraines, Obesity and Medication Burden on Fibromyalgia Impact and Quality of Life

Fibromyalgia (FM) is a common, complex, and chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. A multitude of other central sensitization related symptoms contribute to a profound medication burden and diminished quality of life for affected individuals. We evaluated the impacts of gender, chronicity of headache, migraine, obesity and medication burden on overall FM impact. We used the following validated questionnaires: Fibromyalgia Impact Questionnaire (FIQR), Beck Depression Inventory (BDI), Central Sensitization Inventory (CSI) and measured weight and body mass index (BMI) on a large university cohort of FM subjects. We found that female subjects with FM showed a significant increase in FIQR compared to males with FM. Additionally, we noted positive correlations between weight (Wt) and FIQR, BDI and CSI; BMI and FIQR, and BMI and CSI. Fibromyalgia subjects with a history of migraines (FM-migraine) showed statistically significant increases in FIQR, BDI and CSI compared to FM subjects with no reported history of migraines (FM-non-migraine). There was a steady increase in FIQR, BDI and CSI values with an increase in the frequency of headaches in both the FM -migraine and FM -non-migraine groups. When evaluating BMI, when comparing survey responses of overweight and obese patients to normal weight patients, all FIQR, BDI and CSI values were significantly increased in the various classes of overweight except CSI for the overweight category which appeared to approach significance (p=0.057). There were no statistically significant differences in questionnaire responses for individuals with FM on medications relative to those on no medications. Taken together, a history of migraines and headaches, frequency of headaches and obesity may impact survey responses significantly, negatively impact quality of life and correlate with higher levels of depression but medication burden did not.