Although an exact cause of fibromyalgia is unknown, there are several underlying conditions that contribute to the disorder. Treatment is usually focused on reducing the severity of the symptoms related to the most prominent conditions.
Not getting enough "restful" sleep is thought to be one of the chief underlying causes of fibromyalgia. The body sleeps in stages. Stage four is when the body should be in a deep sleep. This deep sleep is the time that the body has set aside for healing. Tests show that stage 4 of the sleep cycle in fibromyalgia sufferers is interrupted. More conclusive results came about when researchers continuously interrupted the stage 4 sleep of people who had previously never had signs or symptoms of fibromyalgia. As a result of loss of sleep during this critical time, those who had never suffered with fibromyalgia before began to show signs of the disorder. These sleep studies also suggested a direct link between fibromyalgia and a deficiency in the Growth Hormone. This hormone is important in muscle maintenance and repair and is secreted during sleep stage 4.
Neurotransmitter (chemicals that communicate between nerve cells) levels in fibromyalgia patients are often disrupted, causing body wide imbalances. Any of the following neurotransmitters may be disrupted in fibromyalgia, resulting in a wide range of possible symptoms, and requiring different treatments. All of these substances work together, starting and stopping different reactions to allow us to respond to our environment. If they are out of balance, certain reactions that are helpful in moderation may run out of control. The causes of this disruption are unknown.
Acetylcholine - This neurotransmitter controls heart contraction, mucus production in the upper respiratory tract, digestive enzyme secretion, sweating, and the contractions of the stomach, intestines, and eliminatory organs. Involuntary motion and thoughts are also associated with improper levels of acetylcholine.
Adrenaline and Noradrenaline - These complementary neurotransmitters are most known for their connection with stress, and the 'fight or flight' response system. They both regulate energy consumption in the body. Adrenaline is associated with sugar metabolism and insulin production, and is thought to be released into the body too quickly in response to carbohydrates in reactive hypoglycemics. Noradrenaline inhibits digestion, and lowers the body temperature and pain threshold. High levels of these chemicals can create a restless, oversensitive, high anxiety state that may quickly burn out the body's energy reserves. Low levels can cause an apathetic, low energy state, common in fibromyalgia.
Dopamine - This neurotransmitter controls motor activity and concentration. Too much can cause muscle cramps and anxiety, while too little may lead to fatigue and lethargy. ADD and ADHD, more common in fibromyalgia patients, are sometimes associated with low levels of dopamine in certain areas of the brain.
GABA ( gamma-amino-n-butyric acid ) - GABA affects both mood and muscle tone. Low levels can be responsible for muscle spasm and tightness, as well as mood and memory dysfunction.
Histamine - This chemical is released in our bodies when we are exposed to either a trauma or a toxin. Sometimes histamine production is too high, raising the body's alarm system when there is no danger. This is how common allergies occur, and why antihistamines are so effective. (A different mechanism is at work in food intolerance, as opposed to allergy.) Excess histamine production may result in red, watery eyes, headache, stomach upset, or low blood pressure.
Serotonin - A disruption (usually a deficiency) of serotonin is common in fibromyalgia. This chemical regulates mood, digestion, weight, sleep, blood pressure, pain sensitivity, and motivation. Individuals who are prone to migraine or nonrestorative sleep are especially likely to have deficiencies in serotonin. SSRIs (selective serotonin reuptake inhibitors) work by increasing levels of this chemical, and this may be why they are effective for some patients.
Substance P - This chemical regulates pain sensations, stomach contractions, blood pressure and mucus production.
Peptides - These chemicals are related to how individuals feel pain. Many people have heard of endorphins, which are the 'feel good' peptides released naturally during moderate exercise. A lack or surplus of any peptides may increase our likelihood of experiencing pain, or reduce our resistance to pain sensations.
Additional underlying factors include deficiencies of nutrients such as magnesium. This can cause muscle cramps upon exertion and upon awakening. It has also been suggested that a buildup of phosphorus in the body may be responsible for the condition. ( Guaifenisin treatment is thought to work by eliminating extra phosporus. ) If that is the case, it suggests an explanation for the normal blood test results often received by fibromyalgia patients. Other possible causes of fibromyalgia symptoms are hypoxia (lack of oxygen in body tissues), muscular injury, muscular atrophy, and emotional stress, digestion, and mood disorders.
Still another possibility is the onset of infections or viral exposures. More than half of fibromyalgia patients said this occurred prior to the onset of their symptoms. Included among these are Lyme Disease (infection that manifests itself as a multi-system inflammatory disease), Human Immunodeficiency virus, Coxsackie virus (common source of infection in children that often causes flu-like symptoms), Epstein-Barr (member of the herpes virus family, often associated with chronic fatigue), or Streptococcus and Parvovirus (virus that can cause joint pain and swelling).
Lack of regular physical exercise seems to be a factor although it is not known whether lack of conditioning promotes pain or vice versa. While exercise is often invigorating for healthy individuals, it can exhaust a fibromyalgia sufferer, sometimes for days.
Sometimes the symptoms began much earlier than the fibromyalgia patient realizes. Thirty percent of patients remember having 'growing pains' in childhood that seemed to disappear before puberty. These pains seem to reappear more severely later on in adulthood.
There is also some indication that fibromyalgia can be hereditary, as it tends to run in families. Incidence of sleep disorders, blood sugar difficulties, headaches or migraine, ADD or ADHD, Asperger's syndrome, irritable bowel, joint problems, and food allergy or intolerance may all be common in the families of fibromyalgia patients. It is unclear how these conditions interact, or what causes what, but in fibromyalgia it often seems like several conditions pile on top of each other.
Information taken from: http://psyweb.com/FMS/fibromyalgia.jsp
Serotonin - A disruption (usually a deficiency) of serotonin is common in fibromyalgia. This chemical regulates mood, digestion, weight, sleep, blood pressure, pain sensitivity, and motivation. Individuals who are prone to migraine or nonrestorative sleep are especially likely to have deficiencies in serotonin. SSRIs (selective serotonin reuptake inhibitors) work by increasing levels of this chemical, and this may be why they are effective for some patients.
Substance P - This chemical regulates pain sensations, stomach contractions, blood pressure and mucus production.
Peptides - These chemicals are related to how individuals feel pain. Many people have heard of endorphins, which are the 'feel good' peptides released naturally during moderate exercise. A lack or surplus of any peptides may increase our likelihood of experiencing pain, or reduce our resistance to pain sensations.
Additional underlying factors include deficiencies of nutrients such as magnesium. This can cause muscle cramps upon exertion and upon awakening. It has also been suggested that a buildup of phosphorus in the body may be responsible for the condition. ( Guaifenisin treatment is thought to work by eliminating extra phosporus. ) If that is the case, it suggests an explanation for the normal blood test results often received by fibromyalgia patients. Other possible causes of fibromyalgia symptoms are hypoxia (lack of oxygen in body tissues), muscular injury, muscular atrophy, and emotional stress, digestion, and mood disorders.
Still another possibility is the onset of infections or viral exposures. More than half of fibromyalgia patients said this occurred prior to the onset of their symptoms. Included among these are Lyme Disease (infection that manifests itself as a multi-system inflammatory disease), Human Immunodeficiency virus, Coxsackie virus (common source of infection in children that often causes flu-like symptoms), Epstein-Barr (member of the herpes virus family, often associated with chronic fatigue), or Streptococcus and Parvovirus (virus that can cause joint pain and swelling).
Lack of regular physical exercise seems to be a factor although it is not known whether lack of conditioning promotes pain or vice versa. While exercise is often invigorating for healthy individuals, it can exhaust a fibromyalgia sufferer, sometimes for days.
Sometimes the symptoms began much earlier than the fibromyalgia patient realizes. Thirty percent of patients remember having 'growing pains' in childhood that seemed to disappear before puberty. These pains seem to reappear more severely later on in adulthood.
There is also some indication that fibromyalgia can be hereditary, as it tends to run in families. Incidence of sleep disorders, blood sugar difficulties, headaches or migraine, ADD or ADHD, Asperger's syndrome, irritable bowel, joint problems, and food allergy or intolerance may all be common in the families of fibromyalgia patients. It is unclear how these conditions interact, or what causes what, but in fibromyalgia it often seems like several conditions pile on top of each other.
