# Relationship between pain, functionality, and body composition in patients with fibromyalgia: cross-sectional study

## TL;DR

This study explores how pain, physical function, and mental health are connected in women with fibromyalgia, finding that depression and pain significantly impact daily functioning.

## Contribution

The study provides new insights into the relationships between psychological distress, physical performance, and disease impact in fibromyalgia patients.

## Key findings

- Depression correlates with impaired physical performance in functional tests like 5-STST and TUG.
- Pain and depressive symptoms independently contribute to higher fibromyalgia impact scores.
- No significant associations were found between body composition and pain or disease impact.

## Abstract

Fibromyalgia (FM) is a chronic disorder characterised by widespread pain, central sensitisation, and significant psychosocial burden. Patients often present impaired functional capacity, heightened pain perception, and high rates of anxiety and depression. However, the interplay among physical function, psychological distress, and body composition remains insufficiently clarified.

This cross-sectional study included 80 women with clinically diagnosed FM, aged 18–75 years, recruited from the Afinsyfacro Association (Madrid, Spain). Assessments comprised sociodemographic and clinical variables, functional tests [5-Sit-to-Stand test (5-STST), handgrip strength (HGS), Timed Up and Go (TUG), and 4-m gait speed], algometry, bioimpedance, and validated questionnaires (FIQ, HADS, PSQI, VAS). Correlations between pain, fibromyalgia impact, psychological symptoms, physical performance, and body composition were analysed using Pearson’s or Spearman’s coefficients, as appropriate.

Participants reported severe pain (VAS = 7.03 ± 1.94) and a high disease impact (FIQ = 65.27 ± 16.07). The scores obtained on the HADS-A and HADS-D questionnaires were 12.65 ± 4.56 and 9.93 ± 4.56, respectively. Moderate correlations were observed between depression and both the 5-STST (r = 0.325, p < 0.01) and TUG (r = 0.346, p < 0.01), while fibromyalgia impact correlated with all functional measures except HGS. Pain correlated with both anxiety (r = 0.477, p < 0.01) and depression (r = 0.430, p < 0.01). No significant associations were found between body composition variables and FM impact or pain. The overall fit was significant, F(4, 63) = 23.169, p < 0.001. Pain (VAS) and depressive symptoms (HADS-depression) contributed independently to higher FIQ.

Effective management of FM requires a multidisciplinary approach integrating therapeutic exercise, pain management, psychological support, and strategies to optimise body composition and overall health. This holistic perspective may reduce symptom burden and improve quality of life in affected individuals.