Symptoms in women with fibromyalgia after performing physical activity: the role of pain catastrophizing and disease impact, 2022, López-Gómez et al

Abstract

Introduction

Walking is an effective treatment for symptoms’ management in patients with fibromyalgia. However, despite its benefits, fibromyalgia patients face a variety of obstacles that result in reduced ability to sustain physical exercise. The main goal of the study was to analyze the role of pain catastrophizing and fibromyalgia impact in the relationship between regular walking behavior and pain and fatigue experienced after a laboratory walking test.

Method
The study has an observational analytical laboratory design. A total of 100 women were contacted by the research team. Seventy-six women diagnosed with fibromyalgia aged 18 years and older (mean age = 55.05, SD = 7.69) participated.

Results
Significant correlations were found among regular walking behavior, pain catastrophizing, impact of fibromyalgia, pain intensity after walking, and fatigue intensity after walking. The serial multiple mediation analyses confirmed that pain catastrophizing and impact of fibromyalgia mediated the relationship between regular walking behavior and the level of pain (beta B = 0.044, 95% CI = [0.01–0.012]) and fatigue (beta B = 0.028, 95% CI = [0.01–0.08]) after the laboratory walking test. Also, the participants that walked less regularly experienced more pain and fatigue after the 6-Minute Walk Test.

Conclusions
Considering cognitive variables alongside the impact of fibromyalgia will help understand the inhibitors of engaging in physical activity. Therapeutic walking programs must be tailored to patients with fibromyalgia to reduce pain and fatigue related to physical activity and to promote better functioning and quality of life.

Key Points
• Regular walking behavior was associated with fibromyalgia impact, pain catastrophizing, and less pain and fatigue after physical activity.
• When patients catastrophize pain, they usually interpret physical activity as threatening, which generates more pain and fatigue after doing exercise.
• Therapeutic programs should be designed to reduce pain catastrophizing and fibromyalgia impact.

Open access, https://link.springer.com/article/10.1007/s10067-022-06342-5

 

People with more severe symptoms and pain don't walk as much because it hurts them more. Or as they are biasing this using "pain catastrophizing" those that walk less are in more pain because they walk less. Its not hard to see it doesn't naturally follow.

 

I wish the researchers could live in the bodies of the sick people before they stick a nasty label and prescribe cognitive therapy to correct behaviours. They have no understanding.

I mean what if the patients were honest about what is happening in their body and it was a physical (ie biological) process going on that could not be fixed with 'therapeutic' intervention to correct catastrophizing?

 

There is a well known mountaineering book by Lionel Terray called "Conquistadors of the useless", which for some reason comes to mind. Any research involving "pain catastrophisation" should be ignored. The term is clearly judgmental and prejudicial, and is an express indication of lack of sympathy bordering on contempt for the patients' experience.

 

Are they saying irrationally believing something will be painful makes it actually more painful? Does this mean if I believe I will win the lottery that it is more likely I will win the lottery? Or are they saying rationally expecting pain but not being stoical makes it more painful?

Have they ever wondered if rationally knowing you will experience pain if you exercise and then being reluctant to exercise is in fact a rational response?

 

Whoa, the term pain catastrophizing is incredibly offensive, condescending, and probably sexist since most people with fibro are women, and all the subjects in this study were women. I'd like to see researchers focus more on identifying causes and treatments for fibromyalgia rather than focusing on sufferers' psychological reaction to pain.

 

The level of bias in so-called evidence-based medicine is straddling the parody line. Typical "when have you stopped beating your wife?" pseudoscience.

Not sure where these people got the idea that walking is some magical cure for chronic pain. As if people just literally stop walking entirely. There is a weird fetish in healthcare about recreational exercise, as if it's somehow different than regular activity in daily living, most people walk more than enough by simply existing.

If exercise were so magical and good for health, the most labor-intensive workers out there would be the healthiest out there and live the longest. They obviously don't.

 

what kills me is that since FM is so prevalent (5% of population, mostly women, but perhaps more men with the loosening of the definition), where are the physicians, the psychologists, the allied health care workers (physiology, OT, nurses) with fibromyalgia and why is no one talking back?

 

@Andy, thanks for continuing to post fibro research. Even when I find an article objectionable, I do like knowing what the current research trends are in fibro.

 

Do these people never have pain?

And good grief, walking is not a cure for FM, nor is it effective symptom management.

I'd have to look it up again, but FM has symptoms additional to pain.

 

This group in a university psychology department in Spain do a lot of studies about FM and walking and pain and castastrophizing and why won't patients just follow our prescription of walkikng.

From now on, when I read the word "catrastrophizing," I know that it's an objective state where psychologists are tearing their hair out because they don't know why people aren't feeling and behaving the way the psychologists think they should be doing.

It's a catastrophy for the psychologists.

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Sexism is the name of the game here. Also, the lack of an "honorable" reason for the pain, and an unknown pathology, are two more reasons people may not view fibromyalgia symptoms as legitimate. Even Trudie Chalder wouldn't do a study on "pain catastrophizing" in male wounded veterans or men disabled by industrial accidents.

 

No but she has no issue trying to blame chronic fatigue in Men on childhood trauma that doesn't exist so therefore must be repressed. There is sexism but men with Fibromyalgia and ME/CFS have the same problem whether they see a man or a women.

 

"honorable reason for the pain", I think that's an excellent way to put it.

Beyond terrible that the go-to explanation for mystery diseases is that their psychological, or caused by character flaws - lazy, scheming etc.