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Emotional distress and loneliness are factors commonly related to pain and suffering. However, no study has analyzed how all these variables interplay in individuals living with fibromyalgia. The study objective was to empirically test the relationships among loneliness, anxiety, depression, pain, and suffering in this population. Descriptive, observational, cross-sectional study. Structural equation modeling (SEM) was used to assess the relationships between loneliness, anxiety, and depression to the experience of pain and suffering in 317 fibromyalgia patients who attended a specialized pain management facility. Loneliness was positively associated with anxiety, pain, depression, and suffering. Moreover, in our sample, anxiety, depression, suffering, and pain demonstrated significant covariation. We also found that depression is positively related to pain and suffering. Our study demonstrates that loneliness in fibromyalgia is closely linked to anxiety, depression, pain, and suffering. Regular, comprehensive interventions that incorporate social support strategies may help reduce this burden.<\/jats:p>","DOI":"10.1007\/s00296-025-06036-6","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T10:25:23Z","timestamp":1769509523000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Loneliness is associated with depression, anxiety, pain, and suffering in fibromyalgia: results from a structural equation modeling analysis"],"prefix":"10.1007","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4352-8513","authenticated-orcid":false,"given":"Juan Pablo","family":"Rom\u00e1n-Calder\u00f3n","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9961-1722","authenticated-orcid":false,"given":"Camila Andrea","family":"S\u00e1nchez Salazar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4845-4752","authenticated-orcid":false,"given":"Jos\u00e9 Hugo","family":"Arias Botero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2118-5692","authenticated-orcid":false,"given":"Alicia","family":"Krikorian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"issue":"3","key":"6036_CR1","doi-asserted-by":"publisher","first-page":"186","DOI":"10.55563\/clinexprheumatol\/i19pig","volume":"130","author":"P Sarzi-Puttini","year":"2021","unstructured":"Sarzi-Puttini P, Giorgi V, Atzeni F, Gorla R, Kosek E, Choy EH et al (2021) Fibromyalgia position paper. 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