Background/Purpose: Mindfulness is attention to and awareness of present experiences (e.g. physical sensations, emotions, thoughts) in a nonjudgmental way. Initial evidence suggests that increased mindfulness may be associated with less pain intensity and catastrophizing among some people with chronic pain. However, this has not been confirmed among people with fibromyalgia. We evaluated whether greater mindfulness is associated with less pain and severity of associated symptoms in people with fibromyalgia.  

Methods: We performed a secondary analysis of baseline data from a randomized clinical trial comparing Tai Chi to aerobic exercise in fibromyalgia patients as defined by the ACR criteria. At their baseline evaluation, subjects completed the Five Facet Mindfulness Questionnaire (FFMQ), a 39-item, self-report questionnaire that measures five facets of mindfulness: observing, describing, acting with awareness, non-judging, and non-reacting to inner experience. Higher scores in each facet indicate higher levels of mindfulness. Subjects also completed validated symptom measures including the PROMIS Pain Impact Short Form (PROMIS pain), Symptom Severity Scale, and the revised Fibromyalgia Impact Questionnaire (FIQR).We calculated Pearson’s correlation coefficients to assess associations between mindfulness and measures of fibromyalgia pain impact and symptom severity. We determined an overall mindfulness score by calculating a mean of the five facets for each participant.  We also completed a multivariate regression analysis to control for age, gender, body mass index, and education.

Results: Our analysis included data from rounds 1-4 (160 participants) with a mean age of 51.9 (SD=12.2) years; 92% women, mean BMI 29.5 kg/m², and 83% completed at least some college. Higher global mindfulness scores were associated with lower symptom severity and pain intensity as measured by the PROMIS Pain, Symptom Severity, and FIQR (see table). These relationships were also significant for most of the sub-facets of mindfulness with the exceptions of observing and non-reacting. Mindfulness remained independently associated with PROMIS pain, Symptom Severity, and FIQR after adjusting for confounders.

Conclusion: Our results suggest that greater mindfulness is associated with less pain impact and severity of associated symptoms in people with fibromyalgia. Thus, mindfulness-based interventions may have the potential to improve the way those with fibromyalgia relate to their symptoms, by increasing non-judgmental acceptance of their experience, resulting in a reduction of their perception of pain intensity. Longitudinal studies are in progress to assess whether the cultivation of mindfulness alters the severity and prevalence of associated symptoms and experience of pain in people with fibromyalgia amongst those with other chronic pain disorders.