What causes fibromyalgia?
The cause of fibromyalgia is currently unknown. Over the past few decades many theories have been presented, and the understanding of the disorder has changed dramatically. Most current theories explain only a few symptoms of the disorder and are thus incomplete. Many experts believe that fibromyalgia is not a disease but rather a chronic pain condition brought
on by a constellation of dysfunctional biologic responses to stress. Such individuals are thought to be more susceptible to stress because of traumatic personal histories, genetic factors, or both. Physical injuries, emotional trauma, or viral infections, such as Epstein-Barr, may act as triggers for the onset of the disorder, but none have proven to be a cause of primary fibromyalgia.
The sleep disturbance theory postulates that fibromyalgia is related to sleep quality. Sleep disturbances are common in fibromyalgia. Pain is certainly a factor. In addition, fibromyalgia patients have more sleep disturbances than others. Specifically, both adult and young patients have a higher than average incidence of a sleep disorder called periodic limb movement disorder (PLMD), (formerly known as nocturnal myoclonus). In this condition, the leg muscles involuntarily contract every 20 to 40 seconds during sleep, occasionally arousing the patient, who, however, is usually unaware of the cause of the interruption. Circumstances that interfere with "stage 4" deep sleep (such as drug use, pain, or anxiety) appear to be able to cause or worsen the condition. According to the sleep disturbance theory, an event such as a trauma or illness causes sleep disturbance and, possibly, some sort of initial chronic pain. These initiate the disorder. The theory supposes that "stage 4" sleep is critical to the function of the nervous system, as it is during that stage that certain neurochemical processes in the body "reset". In particular, pain causes the release of substance P in the spinal cord, and substance P has the effect of amplifying pain and causing nerves near the initiating ones to become more sensitive to pain. Under normal circumstances this just causes the area around a wound to become more sensitive to pain, but if pain becomes chronic and body-wide then this process can run out of control. The sleep disturbance theory holds that deep sleep is critical to reset the substance P mechanism and prevent this out-of-control effect.
Another theory involves phosphate and calcium accumulation in cells that eventually reaches a level to impede the ATP process, possibly caused by a kidney defect or missing enzyme that prevents the removal of excess phosphates from the blood stream. This theory posits that fibromyalgia is an inherited disorder, and that phosphate build up in cells is gradual (but can be accelerated by trauma or illness). Calcium is required for the excess phosphate to enter the cells. The additional phosphate slows down the ATP process; however the excess calcium prods the cell to continue producing ATP. While this theory does not identify the causative mechanism in the kidneys, it proposes a treatment known as guaifenesin therapy. This treatment involves administering the drug guaifenesin to a patient's individual dosage, avoiding salicylic acid in medications or on the skin, and, if the patient is also hypoglyemic, a diet designed to keep insulin levels low. The phosphate build-up theory explains the myriad symptoms present in fibromyalgia and provides an underlying cause. The treatment has had wide success when followed properly. As it is rather new, however, no successful clinical trials involving the treatment in its entirety have been conducted to date.
Other theories relate to various toxins from the patient's environment, viral causes, growth hormone deficiencies, neurotransmitter disruptions in the central nervous system, and erosion of the protective chemical coating around sensory nerves. Due to the multi-systemic nature of illnesses such as fibromyalgia and chronic fatigue syndrome (CFS), an emerging branch of medical science called psychoneuroimmunology is looking into how the various theories fit together.
More information on fibromyalgia syndrome
What is fibromyalgia syndrome? - Fibromyalgia is a debilitating chronic illness characterized by diffuse pain, fatigue, and a wide range of other symptoms.
What causes fibromyalgia? - The cause of fibromyalgia is currently unknown. Sleep disturbances are common in fibromyalgia. Fibromyalgia is an inherited disorder.
What're the risk factors for fibromyalgia? - Risk factors for fibromyalgia include gender, age, genetic factors, specific lifestyle factors, psychiatric illness.
What're the complications of fibromyalgia? - Fibromyalgia is a common and chronic problem. Fibromyalgia can be mild or disabling, and the emotional repercussions can be substantial.
What are the symptoms of fibromyalgia? - Fibromyalgia symptoms include widespread, diffuse pain, physical fatigue, irritable bowel syndrome, genitourinary symptoms, dermatological disorders.
How is fibromyalgia diagnosed? - Diagnosis of fibromyalgia is difficult. The doctor may make a diagnosis by ruling out other conditions with similar symptoms.
What's the treatment for fibromyalgia? - There is no cure for fibromyalgia. Treatment for fibromyalgia involves conventional analgesics to reduce the effects of fatigue and pain.
What fibromyalgia diet is suggested? - Fibromyalgia patients should maintain a healthy diet low in animal fat and high in fiber, with plenty of whole grains, fresh fruits and vegetables.
What fibromyalgia exercise is suggested? - Low-impact aerobic exercises are effective treatments for fibromyalgia. Exercise regimens are most beneficial when performed on an every-other-day basis.
Fibromyalgia pain relief medications - Pain relief is of major concern for patients with fibromyalgia. Acetaminophen (Tylenol) is often used for mild pibromyalgia pain relief.