Abstract
BackgroundLeading theories about the pathogenesis of fibromyalgia focus on central nervous dysregulation or sensitization, which can cause altered perception. There is growing evidence that fibromyalgia involves altered perception not only of pain, but also other sensory stimuli. On this basis, we investigated whether individuals with fibromyalgia are more likely to report subjective loss of hearing, adjusted for audiometrically measured loss of hearing, compared to persons without any musculoskeletal pain disorders. In addition, we studied persons with other musculoskeletal pain than fibromyalgia and persons who did not have any musculoskeletal pain.MethodsThe study includes 44 494 persons from the second health survey in Nord-Trøndelag (HUNT2) who had undergone audiometry and answered a comprehensive questionnaire that mapped fibromyalgia, musculoskeletal pain at various sites and subjective hearing loss. Respondents with other musculoskeletal pain problems than fibromyalgia were divided into two groups with respectively localized and widespread musculoskeletal pain. Data were analyzed with logistic regression models adjusting for age, education, anxiety, depression and hearing thresholds.ResultsIn adjusted analysis, individuals with fibromyalgia had increased likelihood to report subjective hearing loss, compared to persons without fibromyalgia or other musculoskeletal pain (OR 4.578, 95% CI 3.622–5.787 and OR 4.523, 95% CI 3.077–6.647 in women and men). Furthermore, people with local and widespread musculoskeletal pain not diagnosed with fibromyalgia, also had increased likelihood to report subjective hearing loss, compared to people with no musculoskeletal pain. This relationship was greater for widespread pain than for localized pain (OR 1.915, 95% CI 1.627–2.255, and 1.796, 95% CI 1.590–2.029, in women and men with local musculoskeletal pain and OR 3.073, 95% CI 2.668-3.539, OR 3.618, 95% CI 3.225–4.058, in women and men with widespread pain, respectively).ConclusionsOur findings are consistent with the hypothesis that fibromyalgia is related to a general dysregulation of the central nervous system. The same might also be the case for other local and, in particular, other widespread, musculoskeletal pain.
Highlights
Leading theories about the pathogenesis of fibromyalgia focus on central nervous dysregulation or sensitization, which can cause altered perception
Fibromyalgia may be considered as a “discrete diagnosis or as a constellation of symptoms characterized by central nervous system pain amplification with concomitant fatigue, memory problems, and sleep and mood disturbances”[10]
Descriptive account of participants The prevalence of fibromyalgia among participants who answered these questions in HUNT 2 and underwent audiometry testing was 3.3% (N = 1 483)
Summary
Leading theories about the pathogenesis of fibromyalgia focus on central nervous dysregulation or sensitization, which can cause altered perception. In addition to being a chronic, widespread musculoskeletal pain condition without a well-defined cause, fibromyalgia is often accompanied by non-specific symptoms and comorbidities [14,15,16]. These include symptoms such as fatigue, memory and concentration problems [17], sleep disturbances, stomach ache, depressive symptoms and headache [10, 18, 19], and disorders like irritable bowel syndrome (IBS), chronic fatigue syndrome (CFS/ME), interstitial cystitis (IC) and temporomandibular disorder (TMD) [8]
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