By Dr Ananya Mandal, MD
Fibromyalgia is a condition with widespread debilitating pain. It is present in around 0.5-10% of worldwide population with a seven times higher presence among females than males.
Apart from pain there are symptoms of fatigue, sleep disorders, stiffness, headaches, irritable bowel syndrome, memory or concentration problems etc. Bone health is also significantly affected in fibromyalgia patients.
Fibromyalgia’s effects on bone health
The first of many effects on bone health of fibromyalgia is the findings that a large proportion of fibromyalgia patients have low blood levels of 25-OH vitamin D.
Although vitamin D levels are persistently low there are no significant differences in parathyroid hormone or calcium levels. Some patients do have biochemical osteomalacia.
Low vitamin D levels could also be explained by the fact that the patients may be too debilitated to get adequate sun exposure.
On examining the bone mineral density, it is usually seen that fibromyalgia patients have difference in density at the mid-distal site in the radius bone in the hand. This usually indicates a long-term rather than short-term bone loss.
The spine bone mineral density in these patients is also low.
Studies have shown that fibromyalgia patients compared to normal persons are much more likely:-
to be smokers
to have had a previous fracture
to have used steroids or anti-convulsants (drugs used in epilepsy) that increase the risk of getting osteoporosis
to have a family history of osteoporosis and
to be less physically active
Fibromyalgia and osteoporosis
Osteoporosis leaves bones brittle and prone to fractures. A large proportion of fibromyalgia patients may develop osteoporosis. The bone density is lower especially at sites like necks, spinal columns, and hips.
Osteoporosis commonly affects fibromyalgia patients between the ages of 51 to 60 years. It is thought that fibromyalgia sufferers get osteoporosis because of reduced growth hormones.
Those who have family history of osteoporosis are generally at a greater risk of getting the condition. Those of non-Hispanic Caucasian or Asian descent are in addition at a greater risk.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)