What Causes Fibromyalgia?

Even though the cause of fibromyalgia is currently unknown, there is a significant amount of information about different potential causes that have been discovered through many years of research. One prime example is that fibromyalgia can often develop after a physical trauma (i.e., an accident, injury, or severe illness) that seems to work as a trigger. Trauma can affect the central nervous system which then can be diagnosed as fibromyalgia.

In the late 1990’s, Israeli researcher Dan Buskila, M.D. and a team of investigators, conducted a study of the relationship between cervical spine injuries and the onset of fibromyalgia which revealed that FMS was 13 times more likely to occur following a neck injury than an injury to the lower extremities. Also there are Early studies done with Dr. Donaldson’s research team in Calgary, Canada, that hypothesize that with fibromyalgia patients, the most powerful electrical activity in the brain is inappropriately in the slowest brain waves (i.e., EEG slowing).

With this research there is reason to believe that significant physiological changes could happen in the body after a significant trauma, particularly if the neck or upper body is involved.

Research still continues to explore different avenues that could explain the etiology of fibromyalgia. Another example, is some recent studies suggest that there is a strong familial pattern in the occurrence of FMS, which often seems to follow the female side of the family. With this being said, genetic research is of great interest to many researchers.

There is also strong evidence to show major depression is associated with fibromyalgia, although the nature of the association can be controversial. A study that employed functional magnetic resonance imaging to evaluate brain responses to experimental pain among fibromyalgia patients found that depressive symptoms were associated with the magnitude of clinically-induced pain response specifically in areas of the brain that participate in affective pain processing, but not in areas involved in sensory processing which indicates that the amplification of the sensory dimension of pain in fibromyalgia occurs independently of mood or emotional processes.

An alternative theory regarding the cause of fibromyalgia in relationship to psychological conflict proposes that the disorder could be a psychosomatic illness as described by John E. Sarno’s writing related to “tension myositis syndrome”, in which chronic pain is proposed to be a psychic diathesis of the mind’s subconscious strategy of distracting painful or dangerous emotions. Education, attitude change, and in some cases, psychotherapy are proposed as treatments.

Furthermore, the neurotransmitter serotonin (which modifies the intensity of pain signals entering the brain) appears to be deficient in patients with fibromyalgia. In fact, many of the medications currently used to treat fibromyalgia work to counteract this deficit. While it is becoming increasingly clear that there is a breakdown in the pain perception system in fibromyalgia patients, it is not yet known if the problem is related to allodynia (an increase in pain perception which occurs even though the stimuli sent from the various parts of the body are basically normal) or hyperalgesia (a “hyper” response to real pain stimuli).

Not long ago, medical researchers viewed fibromyalgia syndrome as a discrete medical entity. Increasingly, however, FMS is being seen as a condition which overlaps significantly with certain other systemic illnesses along with a number of regional conditions that affect particular body organs. One of the earliest proponents of this point of view was University of Illinois researcher Muhammad Yunus, M.D., who developed the concept of Dysregulation Spectrum Syndrome (DSS).

DSS is an umbrella term for a number of associated conditions that share common clinical characteristics and a similar bio-physiological mechanism. Dr. Yunus includes nine conditions besides FMS in his DSS family: chronic fatigue syndrome (CFS), irritable bowel syndrome, tension headaches, migraine headaches, primary dysmenorrhea, periodic limb movement disorder, restless legs syndrome, temporo mandibular pain syndrome, and myofascial pain syndrome. He predicts that future research will add new members.

With this perspective, the long list of symptoms/syndromes associated with fibromyalgia can be seen in a special context rather than as one long, baffling list of seemingly incongruent complaints. When FMS and allied conditions are viewed as part of a spectrum, new, coordinated, multi-disciplinary approaches to research and treatment can be undertaken.

There is still much disagreement among researchers and patients alike regarding the extent to which systemic conditions like fibromyalgia syndrome, chronic fatigue syndrome, Gulf War syndrome, and multiple chemical sensitivities are similar, or even identical, conditions. The overall concept of overlap encourages significant changes in the thinking which has revolved around FMS.