Fibromyalgia and hand diseases: A case-control study

Background: Fibromyalgia is a chronic disorder characterized by widespread pain, fatigue, and other systemic symptoms. While fibromyalgia is associated with generalized musculoskeletal complaints, little is known about its relationship with specific hand disorders that impact function and quality of life. Purpose: To determine whether fibromyalgia is associated with an increased prevalence of hand diseases—including carpal tunnel syndrome, De Quervain’s tenosynovitis, trigger finger, tendinitis, and hand osteoarthritis—and to assess healthcare utilization patterns and surgical intervention. Study Design: Retrospective, population-based, matched case-control study. Methods: We used electronic health records from Leumit Health Services, an Israeli healthcare provider serving 750,000 enrollees. The study included adults aged 18-90 diagnosed with fibromyalgia between 2002 and 2023, confirmed by board-certified rheumatologists using the 2010 ACR criteria. Controls were matched 5:1 by age, sex, and enrollment year. Hand diseases were diagnosed using ICD-9 codes, which were confirmed by repeated documentation. Surgical interventions and hand-related healthcare utilization were extracted from administrative records. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression, with significance determined by p < 0.05 and Benjamini-Hochberg correction. Results: The study included 9232 fibromyalgia patients and 46,160 controls (mean age 47.6 years; 86.8% female). Fibromyalgia was significantly associated with increased odds of carpal tunnel syndrome (OR 2.98 [2.80-3.16]), trigger finger (OR 1.77), De Quervain’s tenosynovitis (OR 1.96), tendinitis (OR 2.16), and hand osteoarthritis (OR 2.99) (all p < 0.001). Fibromyalgia patients also had higher healthcare utilization and surgical procedure rates, including carpal tunnel release (OR 2.57) and trigger finger repair (OR 2.98). Conclusions: Fibromyalgia is associated with a significantly higher prevalence of hand diseases and related surgical interventions. These findings support the need for early screening and multidisciplinary management of hand pathology in fibromyalgia patients to improve outcomes and prevent disability.