Severe fibromyalgia affects people with higher body mass index to a disproportionate degree, indicating that weight contributes to the severity of symptoms. Multidisciplinary treatment that combines medical and complementary features is the only effective treatment for severe fibromyalgia.

Severe fibromyalgia can have tremendous impact on quality of life. An August 2011 study published in the journal Health and Quality of Life Outcomes looked at 203 patients with varying levels of fibromyalgia pain, sleep disturbance, depression, and anxiety using a total of five different questionnaires. The study found that 66% of patients could be classified as suffering from moderate to severe fibromyalgia and that the severity of symptoms was directly related to quality of life in terms of productivity, happiness, and general self-esteem. People with moderate to severe fibromyalgia missed an average of 1.8 work days per month, which is roughly three times the average for the general population. Fifty percent of patients in the study reported disruption to their employment as a result of their disease.

Weight and Severe Fibromyalgia

While the cause of fibromyalgia is unknown, there are certain risk facts that seem to have an impact on the severity of symptoms. One of the most important is weight. In a 2011 study in the journal Arthritis Care & Research, doctors at the Mayo Clinic found that an increased BMI led to more severe fibromyalgia in terms of symptoms and quality of life.

What is very interesting about the study is that of the 888 patients involved, the BMIs were almost evenly distributed between normal, overweight, obese, and severely obese, suggesting that weight does not cause fibromyalgia. However, the difference in the severity of symptoms across weight groups was statistically significant and suggested that even if weight does not cause fibromyalgia, it certainly contributes to the severity of the symptoms in people who have the disorder. Patients with greater BMIs complained of more physical dysfunction, more lost days of work, more pain, more stiffness, and greater levels of depression.

The results in relationship to weight suggest that exercise may have multiple mechanisms of positive impact in fibromyalgia. It is well know that exercise, even without weight loss, is associated with a decrease in the symptoms of fibromyalgia. It appears that an added benefit of exercise may be that weight loss can decrease symptoms and reduce the severity of fibromyalgia.

Sleep and Severe Fibromyalgia

According to the Mayo Clinic, people with fibromyalgia sleep roughly one third less time than the average individual, a value that increases to almost one half in patients with severe fibromyalgia. In a 2011 study in the Journal of Sleep Research, a correlation between quality and duration of sleep was made with symptom severity. Interestingly, the study also made a correlation between symptom severity and physical activity.

Fibromyalgia is a vicious cycle because flares of pain are generally accompanied by fatigue, both of which reduce an individual’s motivation to exercise. Through no fault of their own, these individuals end up stuck in bed or milling about the house as they try to find relief from their pain. Unfortunately, this all-too-understandable reduction in activity only serves to worsen the symptoms of fibromyalgia. One of the best ways to avoid this vicious downward spiral is to find a fibromyalgia support group. The bond between members can help motivate individuals to keep pushing forward through the tough times and can help to minimize the potential for closing off one’s self at home as pain intensifies. Studies show that symptom severity is dramatically decreased in patients that are active in support groups.

Age and Fibromyalgia Severity

A study in Nursing Research in September of 2011 found an interesting correlation between severity of fibromyalgia and age. Middle aged adults are more likely to have severe fibromyalgia than are older adults. It seems that symptoms are worse at onset of the disease and slowly but consistently decrease over time. The study looked at 533 adults over the age of 50 with fibromyalgia. The group closest to 50 years of age reported more symptoms and more functional limitations as a result of the disease than did older individuals. The reason for this association is not clear.

Treatment in Severe Fibromyalgia

The mainstays of therapy in fibromyalgia are important regardless of severity. Patients need to be aware of sleep, eating, and exercise patterns, take prescriptions medications on a regular basis, and remain active as part of a well-rounded treatment regimen. What is interesting, however, is that the more severe fibromyalgia is, the greater the necessity for a multidisciplinary approach. In other words, those who suffer from mild symptoms can get away with only engaging in a few of the treatment options. For those who suffer from severe fibromyalgia, however, a treatment program must include multiple aspects if it is to succeed.

A July 2011 study conducted in Spain found that patients with severe fibromyalgia required medical treatment, massage, exercise, and thermal therapy to achieve relief in terms of pain, social function, and overall health. While this was only a pilot study, it seems to suggest that severe fibromyalgia is best treated with a combination approach and that medication alone is not enough.

The severity of fibromyalgia is tightly linked to weight, age, and activity level. While no one can control how fast she ages, weight and activity are well within the control of the individual. As both are related to exercise, the tie to severity between these further supports the notion that exercise is one of the most important aspects of any fibromyalgia treatment regimen. Severe fibromyalgia is a major personal and societal burden that deserves more attention in research.