Prevalence of Fibromyalgia and Its Associated Factors in Saudi Arabia: An Updated Systematic Review

Objectives: Fibromyalgia Syndrome (FMS) is a chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, sleep disturbance, cognitive dysfunction and psychological distress. Epidemiological evidence from Saudi Arabia remains limited and heterogeneous. Objective: To synthesize evidence on the prevalence of fibromyalgia in Saudi Arabia and identify associated demographic, psychological, lifestyle and clinical factors. Methods: A systematic review was conducted according to PRISMA guidelines. PubMed, Web of Science, Embase and Google Scholar were searched for articles published before 30th June 2026, with no restriction on the earliest publication date. Eligible studies evaluated fibromyalgia prevalence or associated factors among participants in Saudi Arabia using established diagnostic or screening criteria. Prevalence estimates and associated demographic, psychological, lifestyle and clinical factors were synthesized. Results: The included studies represented diverse community, university, occupational and patient populations with selected clinical conditions. The pooled prevalence was 11.2% (95% CI, 9.09%-13.73%), with substantial between-study heterogeneity (I² = 87.16%). Female sex, anxiety, psychiatric illness, sleep disturbances, chronic comorbidities and lifestyle and occupational factors were associated with fibromyalgia. Variations in diagnostic criteria, sampling strategies and population characteristics may have contributed to heterogeneity. Conclusion: Fibromyalgia was prevalent across the populations studied; however, the diversity of the included populations limits interpretation of the pooled estimate as a nationally representative prevalence for Saudi Arabia. However, its occurrence is associated with demographic, psychosocial, clinical and lifestyle factors. Standardized diagnostic criteria and longitudinal studies are needed to improve the comparability of evidence and clarify associated factors.