Introduction

There is a surge in awareness that fibromyalgia is not a disease. Whilst it can certainly cause every bit as much impact on the lives of sufferers as any disease and should never be underestimated. Yet ultimately fibromyalgia is a collection of symptoms which makes it more of a ‘syndrome’ than a disease. A syndrome is medicines polite way of saying ‘we dont know what it is but it’s definitely a thing because we see a lot of it’.

While there is so much we don’t know about how and why so many of us get fibromyalgia symptoms (and why so many others don’t). There is a growing body of evidence that forms a compelling trail of breadcrumbs leading to some potentially meaningful and fruitful ways of approaching fibromyalgia. If we understand the possibly causes it gives us something to work with. 

Fibromyalgia Caused by Genetics 

Fibromyalgia Syndrome (FMS) is classified as persistent, widespread musculoskeletal pain, commonly accompanied by symptoms like fatigue, digestive issues, and disruptions in sleep and mood. Approximately two to eight percent of the global population is believed to be impacted by fibromyalgia. Fibromyalgia doesn’t follow a straightforward inheritance pattern within families. However, first-degree relatives of individuals with fibromyalgia, like siblings or children, face approximately eight times higher risk of developing the condition compared to the general population. It’s common for people with fibromyalgia to have family members affected by conditions such as headaches, irritable bowel syndrome, and temporomandibular joint dysfunction, which also involve chronic pain. This suggests a potential clustering of related disorders within families, possibly due to shared genetic risk factors. But also possibly due to shared stresses, environments and lifestyle choices. There is still so much we don’t know.

Fibromyalgia Caused by Infections

While a variety of triggers of fibromyalgia exist, infections such as the hepatitis C virus, HIV and Lyme disease have been associated with the development of the syndrome. However, there is a limitation in the relationship between fibromyalgia and infections due to the similarities in presenting symptoms in patients. Interestingly, fibromyalgia patients reported a higher frequency of adverse events after Sars-Cov2 vaccination in comparison with healthy controls.

 A recent study found that out of the 65 fibromyalgia patients, 44 reported exacerbation of diffuse pain, which was substantially higher than the control group (11/65 patients). Furthermore, fibromyalgia patients reported a higher frequency of symptoms such as fatigue, diarrhoea, sweating, tingling sensations, headaches, dizziness, transient respiratory discomfort, and sudden vision blurring. It is likely that in many cases an infection acts as a trigger for fibromyalgia that had been ‘waiting to happen’ in the persons body for some time.

Fibromyalgia Emotional Trauma and Distress

The emotional and psychological impact of traumatic experiences is a significant factor in the development of fibromyalgia. These experiences encompass mental health issues, grief, trauma, abuse, and bullying, all of which can contribute to distress and mental ill-health. Many individuals with fibromyalgia attribute the onset of their symptoms to episodes of depression or other mental health challenges. Traumatic events, such as physical or sexual assaults, as well as grief, are often cited as triggers for fibromyalgia symptoms. Witnessing or experiencing violent incidents, both in childhood and adulthood, can deeply traumatise individuals and lead to long-lasting effects on quality of life.

If you have chronic fibromyalgia the topic of mental / emotional housekeeping should be absolutely paramount. A rapidly growing number of sufferers are seeing great gains in their fibromyalgia treatment purely by healing the likes of childhood trauma.

Fibromyalgia Caused by Bodily Assault, ill-health, and Change.

Bodily assault, ill health, and sudden change are significant factors believed to contribute to the onset of fibromyalgia. A recent study used an online survey of patient perspectives surrounding these causes. Participants often recounted experiences of car accidents, skeletal injuries, and nerve problems, highlighting the impact of damage to the cervical spine. Many described cumulative physical events, such as falls, injuries, or surgeries, which they believed triggered their fibromyalgia symptoms. Surgery, in particular, was cited as a significant factor, with some participants reporting postoperative complications and prolonged recovery periods contributing to their condition. 

Furthermore, significant life changes such as pregnancy, childbirth, hysterectomy, and menopause were frequently identified as onset events, with participants describing the physical and psychological impact of these transitions.

Fibromyalgia Caused by Central Sensitisation

The International Association for the Study of Pain (IASP) describes central sensitisation as an “increased responsiveness of nociceptive neurons in the central nervous system (CNS) to their normal or subthreshold input, causing an amplification of neural signalling within the CNS that elicits pain hypersensitivity”. There is a considerable overlap between central sensitisation and fibromyalgia symptoms (chronic fatigue, sleep disorders, depression, irritable bowel syndrome, chronic daily headache, pelvic pain, etc). While the relationship between central sensitisation and fibromyalgia isn’t fully understood, research suggests that central sensitisation plays a significant role in the development and perpetuation of fibromyalgia symptoms. 

Understanding the mechanisms underlying central sensitisation in fibromyalgia is essential for developing effective treatment strategies that target pain processing in the central nervous system.

Fibromyalgia Caused by Hormonal Imbalance

Hormones play a significant role in modulating pain perception and inflammation, with sex hormones such as testosterone and progesterone showing pain-diminishing properties. Progesterone, in particular, exhibits anti-inflammatory and neuroprotective effects. A recent study observed the relationship between sex hormones and fibromyalgia symptoms. Interestingly, fluctuations in progesterone levels alone influenced pain levels by approximately 25%. Furthermore, when progesterone levels were low, high cortisol levels exacerbated pain, suggesting a complex interplay between these hormones in modulating pain perception. Pain levels were highest during menstruation when sex hormone levels were at their lowest, further highlighting the influence of hormonal fluctuations on fibromyalgia symptoms.

Fibromyalgia and Neurochemical Imbalance

A chemical imbalance in the brain arises when there’s an excess or deficiency of specific neurotransmitters. These neurotransmitters facilitate the transmission of signals between nerve cells, influencing various bodily functions and behaviours. Neurotransmitters like serotonin, noradrenaline, dopamine, and glutamate regulate multiple physiological processes, including pain perception and stress responses. Recent research suggests that individuals with fibromyalgia may exhibit altered pain processing compared to those without the condition. For instance, reduced serotonin and noradrenaline levels may heighten pain sensitivity, while dysregulated dopamine levels can exacerbate stress responses. Furthermore, disturbances in glutamate levels may further complicate the neurochemical landscape of fibromyalgia.