Does the angle of the lumbar spine play a role in the development of fibromyalgia? A cross-sectional MRI-based study

BackgroundFibromyalgia (FM) is a disorder characterized by chronic widespread pain and fatigue, making diagnosis challenging. Early diagnosis is essential for improving the quality of life of FM.ObjectiveThis study aimed to evaluate whether FM can be diagnosed using magnetic resonance imaging (MRI) and to determine whether lumbar paraspinal muscle volume (LPMV) reduces susceptibility to FM by providing spinal balance, based on the hypothesis that alterations in paraspinal muscle structure and lumbar sagittal alignment may reflect neuromuscular adaptations secondary to central sensitization.MethodsThis retrospective cross-sectional study was conducted between July 2020 and March 2024. Thirty-one patients with FM and 32 healthy controls underwent MRI. The parameters evaluated included the intervertebral disc angle (IDA), lumbar lordosis angle (LLA), sacral tilt (ST), lumbosacral angle (LSA), and LPMV. The IDA was measured between the superior and inferior endplates of adjacent vertebrae in the sagittal plane, whereas the LPMV was quantified using Digital Imaging and Communications in Medicine (DICOM) software.ResultsAge (OR = 1.12, p = 0.010) and IDA-4 score(OR = 1.467, p = 0.004) were independent risk factors for FM. LPMV, IDA-1, and IDA-4 values were significantly higher in FM (p < 0.05).ConclusionMRI-assessed spinal angles and LPMVs were associated with FM; however, these findings should not be interpreted as diagnostic or predictive markers. Higher paraspinal muscle volume, increased IDA-4 values, and older age were associated with FM. Given the limited sample size and potential confounders, the results should be interpreted cautiously.