New Onset of Fibromyalgia After Exposure to a Combat Environment: A Longitudinal Cohort Study

Objective Traumatic life events are hypothesized to be triggers for the onset of fibromyalgia. Posttraumatic stress disorder (PTSD) is a common comorbidity of fibromyalgia. However, limited prospective data are available on the development of fibromyalgia after exposure to high magnitude stress. Methods This longitudinal cohort study of US military service members (N = 1761) assessed fibromyalgia and PTSD before and upon return from combat deployment. Fibromyalgia was assessed with the 2010 American College of Rheumatology fibromyalgia questionnaire. The PTSD Checklist Stressor‐Specific Version (PCL‐S) was used to assess symptoms of PTSD. Results The prevalence rates of fibromyalgia in service members at predeployment (males = 2.2%; females = 2.0%) were similar to rates in civilian populations. Following deployment, the prevalence of fibromyalgia increased significantly to 8.0% in males and 11.1% in females ( P 0.05). By odd ratios, service members with PTSD predeployment were 2.96 times more likely to develop fibromyalgia postdeployment, and those with fibromyalgia predeployment were 3.12 times more likely to develop PTSD postdeployment. Conclusions This study provides the largest prospective data to date to support exposure to the stress of deployment to a warzone as a significant factor related to the onset of fibromyalgia. The bidirectional comorbidity between fibromyalgia and PTSD suggests a potential link in the central nervous system and has implications for management.