The causes of Fibromyalgia are not concrete. This understanding can be disheartening for the newly-diagnosed patient who is just looking for answers. Unlike a disease that is characterized by a set of known causes, fibromyalgia is classified as a disorder. This means that although there are a collection of symptoms that are often concurrent, there is no single traceable answer to the question “What causes fibromyalgia?”

What causes fibromyalgia?

There are a few potential causes of fibromyalgia. They almost function more like risk factors than they do as causes, as those with fibromyalgia generally fit into at least one of these categories. In general, those with fibromyalgia receive pain signals and process them differently than do those without this disorder. This can be influenced by a number of different factors.

Fibromyalgia causes

Chemical imbalance

People with fibromyalgia generally have chemical imbalances in the brain that may lead to improper pain processing and hypersensitivity to pain. Serotonin, noradrenaline, and dopamine are present in lower levels in people with fibromyalgia. These chemicals play an important role in sleep, mood, and appetite regulation.

Additionally, these three hormones govern the response to stress and stressful situations. Changes in cortisol levels, the hormone that increases during stressful situations, or sustained cortisol levels, as in chronic stress, may also contribute to the development of fibromyalgia.

Sleep disorders

It is hard to know if sleep disorders are among the causes of fibromyalgia or if fibromyalgia causes sleep disorders. One thing is certain – these two conditions are intertwined and most often present together. People who are unable to achieve deep sleep are more likely to feel pain more intensely. Researchers are examining whether lack of sleep is a primary cause of fibromyalgia.

Genetic factors

While there does not seem to be a definitive genetic link to fibromyalgia, this condition does tend to run in families. Children of mothers with fibromyalgia are particularly susceptible, but it is hard to separate genetic factors from environmental ones.

It may be that the genetic link makes a person more likely to develop fibromyalgia after a triggering event than a person who experiences the same trigger but without the genetic influence.

Physical or emotional trauma

There is some evidence that what causes fibromyalgia is a physical or emotional trauma. These can include injuries due to car accidents or other physical harm. Emotional trauma can include any of the following:

• Witnessing a traumatic event
• Living in a dangerous environment
• Serving in the military in a war zone
• Sexual or physical assault or abuse

How the body processes these events and transforms them into widespread pain remains a mystery to researchers and doctors, but it is very clear that physical or emotional trauma can be one of the primary causes of fibromyalgia.

Infection

Fibromyalgia can be caused by other illnesses or infections. Those with autoimmune disorders or other disorders that cause infection seem to have an increased likelihood of developing fibromyalgia. Diseases like lupus, rheumatoid arthritis, and osteoarthritis are three conditions that are closely associated with fibromyalgia.

There is some research that ties the presence of the herpes simplex-1 virus, the type of herpes virus associated with cold sores, to fibromyalgia, but that research is in its infancy. Regardless of type, viral infection does seem to be one of the potential causes of fibromyalgia.

Hormonal changes

Between 75 and 90% of all fibromyalgia patients are women, which leads doctors to believe that what causes fibromyalgia is largely due to hormones. Estrogen and progesterone work in opposite directions in the brain, with the former stimulating it and the latter relaxing it. When one of these hormones is out of balance, fibromyalgia may develop.

Women between the ages of 20 and 50 are most often diagnosed. These are primary child-bearing years with the influx of pregnancy hormones, followed by the onset of perimenopause and menopause. As women age, their chances of a fibromyalgia diagnosis increase.

Risk factors for fibromyalgia

Risk factors for fibromyalgia are closely associated with the causes and include the following:

• Gender: Men do develop fibromyalgia but in much smaller numbers than women. This could be due to the factors outlined above, but men may be underdiagnosed due to cultural factors. It is generally more culturally accepted in the U.S. for women to express pain, but men are expected to be stoic about pain. There may be many more cases of fibromyalgia in men, particularly among returning veterans and first responders, than are currently diagnosed.
• Genetics: If your mother had fibromyalgia, you are more likely to contract it yourself.
• Illness or injury: Viral infections or other traumatic physical injury can trigger fibromyalgia.
• Traumatic event: The death of a close family member or being a witness to violence can trigger the development of fibromyalgia.

Diagnosis of fibromyalgia can be complicated. If you have any of the above risk factors and experience pain in at least 11 of 18 tender points that lasts longer than three months and is recurring and unresponsive to traditional analgesics, talk to your doctor.

While we may never know what causes fibromyalgia definitively, researchers are beginning to recognize the prevalence of this disorder. This has resulted in a renewed interest in studying the causes of fibromyalgia as well as potential treatments.

If you or someone you love has fibromyalgia, what treatments have been most effective?

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