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Is There Evidence for Surgery Triggering the Onset of Fibromyalgia Syndrome?

Objectives: This study explored evidence for surgery serving as a trigger for the onset of the fibromyalgia syndrome [FMS]. Methods: Rheumatology patients with [N = 144] and without FMS [N = 45, controls] constructed a timeline of all surgeries and pain three and 14 days post-operatively. Dates of onset of FMS and other rheumatological conditions were indicated allowing for analysis of the relationship between the incidence of surgery and condition onset. Results: The mean number of lifetime surgeries was not significantly different between the groups [FMS: 5.7, non-FMS: 4.9], and there were no differences in types of surgery. To test our hypothesis that surgical trauma was a precipitant for onset of FMS, we examined incidence of surgery in the year preceding symptom onset and in the year of symptom onset. In both timeframes, only about 20 percent of patients in both groups reported having a surgery, and the rates were not different between groups. There were no differences in pain between the two groups for pain three days after surgery during any timeframe. There was a significantly higher level of pain [1.8 versus 1.3] 14 days after surgery reported by the FMS group compared with the non-FMS group for surgeries that took place in all years prior to symptom onset [t[87] = 3.8, P < 0.001]. Using general linear modeling, a repeated measures analysis of pain after surgery controlling for gender, age, and disability found a group main effect [FMS: 2.6 versus non-FMS: 2.3; P = 0.06] across all timeframes. Conclusions: There was no evidence for increased incidence of surgery or more pain from surgery in the year prior to symptom onset in FMS patients. In the earlier years not proximal to onset of symptoms, FMS patients reported higher levels of pain after surgery relative to controls suggesting pre-morbid central sensitization.