I have previously written about the first study to examine the association between alcohol consumption, symptom severity, and quality of life of individuals with FM. Treatment of FM is challenging because the drug therapies currently available are expensive and associated with numerous undesirable (understatement) side effects and addiction or tolerance issues. Despite undergoing drug treatment, patients are often left with unrelieved pain, restricted mobility, and reduced physical function.
(Unfortunately for some) Lifestyle interventions, including dietary modifications such as alcohol consumption, have gained popularity as explorations in symptom management.
Several studies have examined the association between alcohol consumption and chronic pain conditions. In one study, regular weekly or daily alcohol consumption was shown to be a significant protective factor for the development of chronic pain. Two studies have also shown that moderate alcohol consumption correlates with a reduced risk of rheumatoid arthritis .
In this current study, researchers are the first to examine the association between alcohol consumption and FM symptom severity and quality of life. Among the 946 adult FM patients (94 % women, mean age of 49 years old) reporting low or moderate alcohol consumption (≤3 or >3 to 7 drinks per week), there was lower FM symptom severity and better quality-of-life scores compared with those who reported no alcohol consumption. However, these associations were not observed in patients who were heavy drinkers (>7 drinks per week) compared with non-drinkers. Drinkers had higher education, less unemployment, lower body mass index, and lower frequency of opioid use than non-drinkers. Thus, their analyses were adjusted for these potential confounders.
Because alcohol consumption consists of complex behaviours that intersect with many social, economic, psychological, and demographic factors, disentangling this complex web of relationships is a challenge. Interestingly, after exploring possible mechanisms for their findings, the researchers speculated that alcohol consumption may reduce FM symptoms and improve quality of life by mediating psychological benefits and stress relief or by promoting factors associated with social integration. Another possible mechanism proposed is central nervous mediation via the modulating gamma-aminobutyric acid (GABA) system. Behavioural and pharmacological therapies that modulate or mimic the effects of GABA production can be promising for FM treatment.
This initial exploration into the relationships between alcohol consumption, symptom severity, and quality of life for FM has posed a number of questions that need to be answered by future studies with stronger study designs. There are limitations associated with cross-sectional study design: information bias is not uncommon in cross-sectional studies providing data on both exposure and outcome variables from questionnaires – questionnaires are administered at the same time in a cross-sectional study and rely on respondent recall, the measurement errors of exposure (ie, alcohol consumption) may be dependent on the measurement errors of the outcomes (ie, quality of life or FM symptoms). Where such dependent bias occurs, the association between exposure and outcome is likely to be inflated. This basically means that these preliminary results should not be used as grounds for advising patients to drink alcohol (Bummer!).
This research sheds new light on plausible hypotheses and mechanisms to consider in future methodologically rigorous studies to improve the well-being of individuals with FM, but does not give us immediate relief.