Study Explores Relationship Between Fibromyalgia, Resilience, Pain Levels


Resilience of participants with fibromyalgia had a stronger protective association among participants with average null or mild pain than with moderate or severe pain.

Study Sheds Light on Relationship Between Fibromyalgia, Resilience, Pain Levels

Credit: Pexels

In a new study, resilience in patients with fibromyalgia was associated with a decrease of average pain and the degree of interference of pain, but not with average pain scores.1

Fibromyalgia affects 4 million US adults, causing pain all over the body.2 The condition also may lead to sleep problems and fatigue. Resilience serves as a coping resource for patients with fibromyalgia to manage the pain, allowing individuals to live with chronic pain and still experience positive emotions and maintain a higher level of functioning.3 Other ways individuals with fibromyalgia may cope with pain is pain relievers, antidepressants, the seizure medication anticonvulsants (pregabalin), yoga, acupuncture, and physical therapy. Meanwhile, vitamin D and exercise can help with fibromyalgia fatigue.4 Studies also revealed cannabis treatment and aerobic and resistance exercise could help subdue fibromyalgia pain.5,6

The study, led by Livia Teixeira, PhD, of the department of surgical specialties and anesthesiology at Botucatu Medical School, Sao Paulo State University, in Botucatu, Brazil, sought to find the relationship between resilience, pain, and functionality in people with fibromyalgia.1

“Our results provide evidence against beliefs that the pain of people with fibromyalgia is related to low psychological resilience and shed light on the complex interrelationships between resilience, pain, and functionality,” the investigators wrote.

The team conducted a cross-sectional online survey, selecting 2176 participants from Brazilian fibromyalgia virtual support groups on Facebook in May 2018. They evaluated resilience by the Connor-Davidson Resilience Scale and assessed average pain and the degree of interference of pain in the lives of participants using the Brief Pain Inventory. The investigators evaluated the relationships through a multivariable robust linear regression and adjusted for 21 potential confounders.

Teixeira and colleagues found resilience was associated with a decreased average pain and the degree of interference of pain (β, -0.38; 95% CI, - 0.54 to -0.22; P <.001). On the other hand, resilience was not associated with a decrease in average pain scores (β, -0.01; 95% CI, -0.18 to 0.16; P = .93)

The findings demonstrated resilience had a stronger protective association among participants with average null or mild pain than with moderate or severe pain.

“This research signals both the relevance and limits of resilience in the management of fibromyalgia,” the investigators wrote. “Future studies evaluating behavioral interventions for fibromyalgia should consider how those interventions interact with baseline pain levels and resilience.”


  1. Teixeira LA, de Oliveira Vidal EI, Blake H, de Barros GAM, Fukushima FB. Evaluating the Interaction between Pain Intensity and Resilience on the Impact of Pain in the Lives of People with Fibromyalgia. Clin J Pain. Published online November 23, 2023. doi:10.1097/AJP.0000000000001178
  2. Fibromyalgia. Centers for Disease Control and Prevention.,be%20effectively%20treated%20and%20managed. Accessed November 29, 2023.
  3. Ramírez-Maestre C, de la Vega R, Sturgeon JA, Peters M. Editorial: Resilience Resources in Chronic Pain Patients: The Path to Adaptation. Front Psychol. 2019;10:2848. Published 2019 Dec 20. doi:10.3389/fpsyg.2019.02848
  4. Story, C. How to Treat Fibromyalgia. Heathline. March 12, 2019. Accessed November 29, 2023.
  5. Pine, L. Cannabis Significantly Improves Quality of Life in Women with Treatment-Resistant Fibromyalgia. HCPLive. November 21, 2022. Accessed November 29, 2023.
  6. Pine, L. Combination Aerobic, Resistance Exercise Routine Improves Symptoms of Fibromyalgia. HCPLive. October 18, 2022. Accessed November 29, 2023.
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