Fibromyalgia is a fairly common condition characterized by long-term, body-wide pain and tender points in joints, muscles, tendons and other soft tissues. Fibromyalgia has also been linked to fatigue, morning stiffness, sleep problems, headaches, numbness in hands and feet, depression and anxiety.
Many people know what fibromyalgia is, but its causes have yet to be identified and confirmed in definite terms. But recent research has generally found that fibromyalgia is most likely a result of what scientists call central sensitization or unusual responses in the nervous system with regard to pain perception.
According to Dr. Bruce Solitar, clinical associate professor of medicine in the division of rheumatology at NYU Medical Center/Hospital for Joint Diseases in New York, “The [current] consensus is that fibromyalgia is not a problem with the muscles, joints or tendons, but rather a problem with the central nervous system.”
While it’s easy to think that pain felt by someone who has experienced no physical damage to the body might be categorized as “all in their head,” the sensations that someone with fibromyalgia experiences are as real as any other pain. Scientists aren’t sure what triggers fibromyalgia but a number of conditions have been linked to the development of it. These include:
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• Infection. The Epstein-Barr virus, influenza, and hepatitis B and C have all been implicated in the development of fibromyalgia. According to Dr. Solitar, These viruses may have long-term effects on the immune system. It’s also possible that viral particles attach to glial cells, which are cells within the brain that affect neurotransmission and influence the pain response. Additionally, there is a well-established connection between Lyme disease and fibromyalgia: Some patients who have been treated for Lyme—and appear to have recovered from it—continue to experience the unusually high frequency of unprovoked pain that characterizes fibromyalgia.
• Trauma. Sometimes the development of fibromyalgia is linked to physical injury, especially in the upper spinal region. In other cases, it’s associated with great emotional stress, like the death of a family member or the loss of a job. The possible link between these unrelated types of trauma is the neurohormonal change that both physical injury and emotional stress can trigger. Psychological processes can change, and can be changed by, alterations in the function of hormone-regulating centers like the hypothalamus and the pituitary and adrenal glands, which in turn affect the nervous system.
• Genes. Found in approximately 2% of the U.S. population (3.4% of women and 0.5% of men), fibromyalgia often develops in multiple members of the same families, although it’s not clear if this is the result of genetic or environmental effects. Family members of those with fibromyalgia seem to be more sensitive to pain and feel more tender when touched than others, but at this time there is no conclusive genetic research to confirm or deny this line of thought.
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