Pain acceptance and its impact on function and symptoms in fibromyalgia

Abstract

ObjectivesFibromyalgia is a chronic widespread pain (CWP) syndrome of unknown etiology with substantial burden of illness and functional impairment. Pain acceptance has emerged as an interesting target of therapy in chronic pain populations, but few studies have yet been done on the effect of pain acceptance on patients with fibromyalgia. The aim of the present study was to examine the relationship between pain acceptance and its impact on function and symptoms in fibromyalgia with both a cross-sectional and longitudinal design.MethodsThree hundred and sixty five participants aged 22–70 with fibromyalgia were recruited from the Norwegian Fibromyalgia Association (NFA). They filled out a questionnaire containing the Fibromyalgia Impact Questionnaire (FIQ), measurement of function and symptoms, and Chronic Pain Acceptance Questionnaire (CPAQ), measurement of pain acceptance, in addition to sociodemographic and clinical variables such as degree of fibromyalgia, depression and pain duration (T1 measures). One year after, 87 of the participants filled out the FIQ and clinical measures once again (T2 measures). Unadjusted and adjusted linear regression analyses were performed both for cross-sectional measures at T1 and for longitudinal measures from T1 to T2, with FIQ score as the outcome variable and CPAQ score at T1 as one of the main independent variables.ResultsHigher CPAQ score was significantly associated with a lower FIQ score at T1, also when adjusting for age, education, work, depression and Fibromyalgianess Score (p<0.01). Lower FIQ score indicate less impact of fibromyalgia on functioning. In addition, two adjusted linear regression models found higher pain acceptance (CPAQ score) at T1 to be associated with lower negative impact of fibromyalgia on function and symptoms (FIQ score) at T2 (p<0.01).ConclusionsHigher pain acceptance is associated with better functional level and less symptoms in fibromyalgia, both cross-sectionally and when measurements are separated in time. Further research should include experimental studies with acceptance-based interventions for this patient group.

Does the Rural Environment Influence Symptomatology and Optimize the Effectiveness of Disease Acceptance? A Study Among Women With Fibromyalgia

“…Studies with mixed samples of patients with chronic pain show that higher levels of acceptance are associated with better daily functioning and less disability and symptoms ( Kratz et al, 2007 ). In patients with fibromyalgia specifically, the previous literature is consistent with the positive role of acceptance in the suffering ( Tangen et al, 2020 ). In this vein, it seems that accepting the disease reduces the levels of anxiety, depression and pain and improves the functioning of these women ( Rodero et al, 2011 ; Yu et al, 2017 ; Lami et al, 2018 ; Trainor et al, 2019 ).…”

Fibromyalgia as a Heterogeneous Condition: Subgroups of Patients Based on Physical Symptoms and Cognitive-Affective Variables Related to Pain

“…Taking into account the most dysfunctional profile represented by Group 1, the low pain acceptance seems to be a relevant variable linked to severity of FM, which is in line with previous research (e.g., Lami et al, 2018;Tangen et al, 2020;Trainor et al, 2019). However, beyond the low pain acceptance, other processes of psychological inflexibility may be involved in FM experience.…”

“…Pain acceptance is defined as the willingness to live with pain with no need to try to change it (Thompson & McCracken, 2011) and evidence suggests that contributes in a powerful way to developing a more constructive pain experience. In FM patients several studies found that pain acceptance was associated with lower emotional distress and disability (Lami et al, 2018), and better functional level and less symptoms (Tangen et al, 2020), and that pain-related psychological flexibility and general psychological acceptance were related to functional status (Trainor et al, 2019). Surprisingly, despite this evidence, no study has considered pain acceptance as a variable of interest in the configuration of FM subgroups.…”

The Role of Pain Catastrophizing and Pain Acceptance in Performance-Based and Self-Reported Physical Functioning in Individuals with Fibromyalgia and Obesity

“…Research has repeatedly shown that pain catastrophizing and pain acceptance are important predictors of self-reported physical functioning in samples with acute [ 104 , 105 ] and chronic pain [ 105 , 106 ], including FM [ 41 , 107 , 108 , 109 , 110 ]. Our findings are consistent with the previous evidence.…”