That question is like the proverbial, “Which came first, the chicken or the egg?” because there is not yet a definitive answer as to the cause of Fibromyalgia Syndrome (FMS). And without knowing the root cause, you cannot solve the problem; you are merely treating the symptoms.

What They Know

Doctors can agree on how to diagnose it, what the symptoms are, and a variety of treatments. But not every patient responds the same to treatment. And the cause of fibromyalgia still eludes the medical community.

From The National Center for Biotechnology Information:

“The etiology of fibromyalgia remains unknown, but recent advances and discoveries have helped to unravel some of the mysteries of this disease. Research highlights some of the biochemical, metabolic, and immunoregulatory abnormalities associated with fibromyalgia. Management of FMS at the present time is very difficult as it has multiple etiological factors and psychological predispositions; however, a patient centered approach is essential to handle this problem.”

Here’s what they do know about fibromyalgia:

• It is a chronic condition that causes widespread pain and fatigue
• Symptoms resemble arthritis, but it is in the soft tissue, not the joints
• Currently there is no cure, but symptoms can be alleviated with things such as medication, diet, and behavioral therapy

Theories

Doctors believe there is a glitch in the brain that causes the brain and spinal cord to misinterpret pain signals. Pain is a way for the body to signal that something is wrong and typically as you heal, the pain fades. For us fibrowarriors, the pain only fades temporarily before surfacing again.

“Glitch” is one of those non-scientific terms used to describe a problem of unknown origin. We hear it all the time, typically as “computer glitch,” and it serves as an excuse to not really get to the root of the problem. Personally, I hate that term. I want to know the WHY behind the WHAT.

From the Mayo Clinic:

“Doctors don’t know what causes fibromyalgia, but it most likely involves a variety of factors working together. These may include:

• Genetics. Because fibromyalgia tends to run in families, there may be certain genetic mutations that may make you more susceptible to developing the disorder.
• Infections. Some illnesses appear to trigger or aggravate fibromyalgia.
• Physical or emotional trauma. Fibromyalgia can sometimes be triggered by a physical trauma, such as a car accident. Psychological stress may also trigger the condition.”

And the medical community cannot agree.

Read a variety of theories from Medical News Today to Healthline to VeryWellHealth, and you will see that various medical sites report that there is a range of likely primary and secondary risk factors, including:

Primary

• Hormone imbalances in serotonin, melatonin, dopamine, norepinephrine, glutamate & GABA, stress hormones, or growth hormones. “A significant number of biochemical and hormonal abnormalities have been identified which point toward fundamental neuro-endocrine abnormalities in patients with FMS.”
• Abnormal pain signaling / central nervous system (CNS) problems. Fibromyalgia patients have qualitative differences in pain perception due to central sensitization.
• Triggers PTSD from a stressful, traumatic physical or emotional event, such as a car accident or the death of a loved one
• Chronic sleep disturbances Up to 80% of patients show a characteristic alpha wave intrusion into normal delta rhythm of stage 4 (non-REM) sleep. Although not specific for fibromyalgia, this irregular sleep pattern may be an important factor contributing to the severity of disease manifestations.
• Muscle abnormalities that are either structural, biochemical, or functional

Lady Gaga “believes her fibromyalgia was sparked by being sexually assaulted when she was 19 and worsened by the physical and emotional pressures of fame and touring. ‘For me, and I think for many others, it’s really a cyclone of anxiety, depression, PTSD, trauma, and panic disorder, all of which sends the nervous system into overdrive, and then you have nerve pain as a result.'”

Secondary

• Autoimmune diseases like rheumatoid arthritis or lupus
• Genetics or the way our genes regulate how we process painful stimuli
• Triggered from a medical issue, such as an injury to the neck, endometriosis, Lyme disease, Hepatitis, an infection like the flu, surgery
• Abnormal blood flow in the brain in the areas that interpret pain (too much blood) and respond to pain (too little blood)

Fibromyalgia has a high occurrence of misdiagnosis, symptoms overlap with many other conditions, and it has a high rate of co-morbidity with other conditions. Getting to a diagnosis may be a chore in and of itself, first ruling out other things.

In the End

It’s quite possible that fibromyalgia does not have one definitive cause, but rather there are many contributing factors. My hope is that the medical community continues to push for that discovery, as well as for effective treatments and/or cures for Fibromyalgia Syndrome. If you’re just starting on your journey to diagnosing and treating FMS, here are some other blogs I have written that might help you:

• Becoming Your Own Health Advocate
• Fibromyalgia Symptom Round-up
• When Everything Hurts

Do you have other thoughts on the cause of fibromyalgia? Please share them. And help me spread awareness by sharing this post.