Fibromyalgia Causes and Risk Factors

Published: September 5, 2017
Last reviewed: September 19, 2017

Causes of Fibromyalgia

Current evidence suggests that fibromyalgia occurs in individuals who are not able or willing to cope with psychological or physical stress [2,3,4,5].

Fibromyalgia is NOT [6,20]:

  • A muscle or joint disorder or an autoimmune disease
  • An infection or inflammation
  • A degenerative nerve disorder [14]
  • A disorder of muscle metabolism [22]
  • A psychiatric disease
  • A genetic disease


Mechanism of Fibromyalgia

According to current research, here is how pain and increased sensitivity in fibromyalgia can develop [1,2,3,8,9,15,20]:

You get into a conflict with people or your work but you do nothing to solve it, so the conflict continues, which makes you increasingly sad or angry.

Your brain interprets the continuing unpleasant emotions as a threat and adapts to them by lowering the threshold for pain and other sensory stimuli. This adaptation is known as central sensitization [20].

Stress may result in constant activation of the sympathetic nervous system, which holds you in a “fight” mode with anxiety, irritability, insomnia, dry mouth or irritable bowel syndrome [15,18]. Such highly activated sympathetic system is less able to react to additional stress, which could explain fatigue, brain fog and a drop in blood pressure upon standing [18].

Currently, it is not known, if mitochondrial dysfunction in the muscles is involved in fibromyalgia [29,30].

Risk Factors

Risk factors for fibromyalgia may include [1,9,10,11,12,13,31]:

  • Perfectionism, self-sacrificing or avoidance personality, compulsiveness, catastrophizing, depression
  • Obesity, physical inactivity
  • Poor job or life satisfaction
  • Poor posture [21,36]
  • Joint hypermobility [36]
  • Painful experiences as an infant, premature birth, lack of emotional support or being abused as a child, maternal drug (morphine, cocaine) abuse during pregnancy [32]
  • Family history of fibromyalgia or alcoholism [32]
  • Arthritis: osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus or ankylosing spondylitis (spinal arthritis)
  • Diabetes mellitus [21]
  • Female sex

Fibromyalgia is not a hereditary disease, so it does not pass directly from parents to children [6]. However, the first-degree relatives of individuals with fibromyalgia are at highly increased risk of developing it [8].

Low levels of serotonin (a chemical messenger in the brain) have been found in individuals with fibromyalgia and often in their healthy siblings [3].

Smoking [33,34] and moderate alcohol consumption [35] do not seem to increase the risk of fibromyalgia.

Triggers of Fibromyalgia Onset

Fibromyalgia can develop due to strong or repeated psychological or physical stress related to [3,6,7]:

  • Emotional trauma, such as loss of job or a close person or sexual abuse associated with fear, anger or resentment
  • Excessive physical work, especially repetitive heavy lifting or bending
  • Monotonous work
  • Lack of sleep

According to several studies, Lyme disease may trigger fibromyalgia, but treatment with antibiotics does not improve the symptoms of fibromyalgia [37].

It is not clear if viruses (Epstein-Barr, HIV/AIDS, hepatitis C, parvovirus) [16,17,18] or Mycoplasma [19] can trigger fibromyalgia.

Common vaccines used in the United States do not seem to trigger fibromyalgia [27].

It is also not clear if a physical trauma including whiplash injury, surgery and childbirth, and menopause can trigger fibromyalgia [7,28]. In various studies, after a whiplash injury, tenderness was usually limited to the neck and shoulder girdle area and lasted only for few months [23,24,25].

Fibromyalgia is not likely caused by a deficiency of minerals or vitamins, such as vitamin A, B1, B12, C, D, folic acid and E, calcium, copper, iron, iodine, magnesium, manganese, molybdenum, phosphorus, potassium, selenium, sodium or zinc [14].

Triggers of Flare-Ups

According to various surveys, the following may trigger fibromyalgia flare-ups, that is a sudden increase in the severity of symptoms [7,8,26]:

  • Emotional stress, excessive worrying, family conflicts, war
  • Excessive work, strenuous activities, travel, lack of sleep
  • Injury
  • Infection
  • Menstruation
  • Menopause
  • Medication side effect
  • Rainy, hot or cold weather
  • References

      1. Fleming KC et al, 2015, Central Sensitization Syndrome and the Initial Evaluation of a Patient with Fibromyalgia: A Review  PubMed Central
      2. Woolf CJ, 2012, Central sensitization: Implications for the diagnosis and treatment of pain  PubMed Central
      3. Bradley LA, 2009, Pathophysiology of fibromyalgia  PubMed Central
      4. Gracely RH et al, 2002, Functional magnetic resonance imaging evidence of augmented pain processing in fibromyalgia  PubMed
      5. Clauw DJ et al, 2011, The Science of Fibromyalgia  PubMed Central
      6. Fibromyalgia  American College of Rheumatollogy
      7. Bennet RM et al 2007, An internet survey of 2,596 people with fibromyalgia  PubMed Central
      8. Kaltsas G et al, 2013, Fibromyalgia  NCBI
      9. Boomershine CS, Fibromyalgia  Emedicine
      10. Questions and answers about fibromyalgia  National Institute of Arthritis and Musculoskeletal and Skin Diseases
      11. Clauw DJ, 2014, Fibromyalgia clinical review  CiteSeerX
      12. Fibromyalgia facts sheet The Centers of Disease Control and Prevention
      13. Hudson JI et al, 2003, Family Study of Affective Spectrum Disorder  Jama Psychiatry
      14. Joustra ML et al, 2017, Vitamin and mineral status in chronic fatigue syndrome and fibromyalgia syndrome: A systematic review and meta-analysis  PubMed Central
      15. Martinez-Lavin M, 2012, Fibromyalgia: When Distress Becomes (Un)sympathetic Pain  PubMed Central
      16. Buchwald D, 1987, The “Chronic, Active Epstein-Barr Virus Infection” Syndrome and Primary Fibromyalgia  PubMed Journals
      17. Harris RE et al, 2008, Newer treatments for fibromyalgia syndrome  PubMed Central
      18. Bellato E et al, 2012, Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment  PubMed Central
      19. Endresen GK, 2003, Mycoplasma blood infection in chronic fatigue and fibromyalgia syndromes  PubMed
      20. Meeus M et al, 2007, Central sensitization: a biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome  PubMed Central
      21. Yunus MB, 2012, The Prevalence of Fibromyalgia in Other Chronic Pain Conditions  PubMed Central
      22. SimmS RW et al, 1994, Lack of association between fibromyalgia syndrome and abnormalities in muscle energy metabolism  PubMed
      24. Tishler M et al, 2011, Can fibromyalgia be associated with whiplash injury? A 3-year follow-up study  PubMed
      25. Haneline MT, 2009, The notion of a “whiplash culture”: a review of the evidence  PubMed Central
      26. Pamuk ON et al, 2009, The variation in chronic widespread pain and other symptoms in fibromyalgia patients. The effects of menses and menopause  PubMed
      27. 2017, Do Vaccines Cause Fibromyalgia or Chronic Fatigue Syndrome?  Institute for Vaccine Safety
      28. Greenfield S et al, 1992, Reactive fibromyalgia syndrome  PubMed
      29. Sánchez-Domínguez B et al, 2015, Oxidative stress, mitochondrial dysfunction and, inflammation common events in skin of patients with Fibromyalgia  PubMed
      30. Meeus M et al, 2013, The role of mitochondrial dysfunctions due to oxidative and nitrosative stress in the chronic pain or chronic fatigue syndromes and fibromyalgia patients: peripheral and central mechanisms as therapeutic targets?  PubMed
      31. Olivieri P et al, 2012, Childhood risk factors for developing fibromyalgia  PubMed
      32. Low LA et al, 2012, Early Life Adversity as a Risk Factor for Fibromyalgia in Later Life  Hindawi
      33. Yunus MB et al, 2002, Relationship between fibromyalgia features and smoking  PubMed
      34. Zvolensky MJ et al, 2010, Chronic Musculoskeletal Pain and Cigarette Smoking among a Representative Sample of Canadian Adolescents and Adults  PubMed Central
      35. Kim CH et al, 2013, Association between alcohol consumption and symptom severity and quality of life in patients with fibromyalgia  PubMed Central
      36. Cohen H, 2017, Controversies and challenges in fibromyalgia: a review and a proposal  PubMed Central
      37. Lantos PM, 2015, Chronic Lyme disease  PubMed

2 Responses to Fibromyalgia Causes and Risk Factors

  1. Jane doe says:

    After reading this I would like to ask a question. I was kidnaped and sexually abused when I was 13 could this be one of the causes for my fibromyalgia?

  2. me says:

    bullshit. you have no idea

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