Background/Purpose: Amongst patients with fibromyalgia, alcohol consumption has been reported in a single clinical study to be associated with lower severity of symptoms. This study aimed to a) determine whether alcohol consumption is associated with the reporting of chronic widespread pain (CWP) in an unselected population sample, and whether a dose-risk relationship is evident; b) amongst persons with CWP confirm whether the level of reported alcohol consumption is associated with symptom severity. 

Methods: The MUSICIAN study sampled patients, aged over 25 years, registered at general practices in two areas of Great Britain. Information, collected by postal questionnaire, included current pain and usual alcohol consumption. Respondents were classified according to whether they satisfied the definition of chronic widespread pain (CWP) in the ACR 1990 criteria for fibromyalgia.  Pain intensity and disability was measured by the Chronic Pain Grade and disabling pain defined as grade III or IV. Respondents reported whether they had ever drunk alcohol regularly and if so how much they currently drank per week (in units). Potential confounders of the relationship collected were: age, body mass index, employment status and amount smoked. Analysis was by logistic regression with those who had never regularly consumed alcohol as the referent group compared with 0-5, 6-10, 11-12, 21-35, 35+ units/week.

Results: 13587 persons participated (mean age 55 yrs, 57% female) of which 2060 reported CWP and answered the questions on Chronic Pain Grade. There was a significant relationship between level of alcohol consumption and risk of reporting CWP. Risk decreased with increasing consumption with the lowest risk amongst those consuming 21-35 units/week (OR 0.61; 95% CI 0.50-0.75) while those consuming higher amounts did not have a reduced risk. This protective effect persisted after adjustment with only minor attenuation of effect (21-35 units/week 0.63; 0.51, 0.78). The effect was evident in both males and females.  Amongst persons with CWP there was a strong and significant relationship between increasing alcohol consumption and lower likelihood of disability (table) which was not explained by measured confounders.

Conclusion: Moderate alcohol consumption was associated with a lower prevalence of CWP and associated with markedly lower levels of disability in those with CWP. One possible mechanism is through alcohol’s agonist effects on the neurotransmitter γ-aminobutyric acid (GABA) and disruptions to GABA pain inhibitory pathways have been suggested in persons with fibromyalgia. Another is through the psychological benefits of alcohol including stress relief and mood enhancement. However alcohol consumption as a marker for other lifestyle factors, or that people avoided alcohol because of their pain and disability, cannot be excluded.