Fibromyalgia and Post-Traumatic Stress Disorder: A Systematic Review

Abstract

Introduction: Fibromyalgia (FM) is considered an idiopathic condition characterised by diffuse and chronic musculoskeletal pain. Emerging evidence suggests that exposure to traumatic events may be associated with an increased likelihood of developing this multifaceted disorder. This systematic review examines the role of post-traumatic stress disorder (PTSD) in the etiology and progression of FM, aiming to synthesise findings from published literature on the PTSD-FM association over the past thirty years. Methods: This review was conducted in accordance with the PRISMA guidelines. Relevant studies published between 1993 and 2023 were identified through a comprehensive search of the PubMed, ProQuest, and Scopus databases. Inclusion and exclusion criteria were applied, yielding a final selection of 20 articles. These studies were assessed based on their methodological quality, as well as the relevance of their objectives, sample populations, and findings. Results: The results indicate an association between FM and PTSD, with some evidence linking PTSD to greater FM symptom severity. Limited evidence also suggests an association between PTSD and increased likelihood of FM development. Conclusion: These findings highlight the need for an interdisciplinary, biopsychosocial approach to the prevention, diagnosis, and treatment of FM and PTSD. Methodological limitations were identified across the included studies, such as the absence of a biopsychosocial perspective, reliance on self-reported PTSD assessments, small and unrepresentative samples, and inconsistent control of psychological factors. Future research should adopt rigorous diagnostic methods, incorporate biopsychosocial frameworks, use larger and more representative samples, and employ longitudinal designs to enhance generalisability and deepen understanding of the relationship between PTSD and FM.