Association between physical exercise, body mass index, and risk of fibromyalgia: Longitudinal data from the Norwegian Nord‐Trøndelag Health Study

Abstract

Objective. To examine the association between leisure time physical exercise, body mass index (BMI), and risk of fibromyalgia (FM). Methods. A longitudinal study with baseline assessment of physical exercise (frequency, duration, and intensity) and BMI was used to explore the risk of having FM at 11-year followup in a large, unselected female population (n ‫؍‬ 15,990) without FM or physical impairments at baseline. Results. At followup, 380 cases of incident FM were reported. A weak dose-response association was found between level of physical exercise and risk of FM (for trend, P ‫؍‬ 0.13) where women who reported the highest exercise level had a relative risk (RR) of 0.77 (95% confidence interval [95% CI] 0.55-1.07). BMI was an independent risk factor for FM (for trend, P < 0.001), and overweight or obese women (BMI >25.0 kg/m 2 ) had a 60 -70% higher risk compared with women with normal weight (BMI 18.5-24.9 kg/m 2 ). Overweight or obese women who exercised >1 hour per week had an RR of 1.72 (95% CI 1.07-2.76) compared with normal-weight women with a similar activity level, whereas the risk was >2-fold higher for overweight or obese women who were either inactive (RR 2.09, 95% CI 1.36 -3.21) or exercised <1 hour per week (RR 2.19, 95% CI 1.39 -3.46). Conclusion. Being overweight or obese was associated with an increased risk of FM, especially among women who also reported low levels of physical exercise. Community-based measures aimed at reducing the incidence of FM should emphasize the importance of regular exercise and the maintenance of normal body weight.

Physical Activity to Reduce Systemic Inflammation Associated With Chronic Pain and Obesity

“…Obesity has consistently been identified as a factor contributing to a variety of pain conditions [2], including chronic widespread pain [34], fibromyalgia syndrome [4], neck, back and shoulder pain [35,36], sciatica [37] and chronic daily headache [9]. Obesity has also been found to be positively correlated with the incidence and severity of pain [1,4,5,26,35,36,38,39].…”

“…Evidence suggests that there is a positive correlation between obesity and chronic pain (for review see [1]). A reduction in body fat can improve the symptoms and disability associated with chronic musculoskeletal pain including knee osteoarthritis, low back pain, hip and ankle pain, headaches, and chronic widespread pain and fibromyalgia syndrome [1][2][3][4][5]. Evidence suggests that improvement in pain outcomes associated with weight reduction is mediated by a decrease in load on weight bearing joints [6] improvement in joint alignment [7] and improvement in posture (see [5] for review).…”

“…The presence of proinflammatory cytokines in the systemic circulation may provide a common link between obesity and hronic musculoskeletal pain [4,5]. It has been suggested that interventions, such as physical activity, which target both systemic inflammation and obesity could reduce pain [1].…”

Chronic Pain in the Obese Population: Is Exercise The Key?

“…Research suggests that weight loss reduces the levels of proinflammatory markers in fibromyalgia [12], low back pain [13] and osteoarthritis of the knee [4]. It has also been claimed that exercise itself has a prophylactic effect on the development of some pain conditions such as fibromyalgia syndrome, and neck, shoulder and back pain [14]. Evidence from large population cohort studies suggests that exercise reduces systemic inflammation independent of weight loss [15].…”

Psychosocial work stress, leisure time physical exercise and the risk of chronic pain in the neck/shoulders: Longitudinal data from the Norwegian HUNT Study

“…Longitudinal studies have shown that leisure time physical exercise reduces the risk of chronic neck/shoulder pain [10][11][12][13][14], while obesity increases the risk [14,15]. Physical exercise has also been shown to attenuate the adverse effect of excess body mass on the risk of chronic neck/shoulder pain [14,16]. It may, therefore, be hypothesized that physical exercise has a compensatory effect on other possible risk factors for neck/shoulder pain, such as stressful work.…”