Well, there is a short answer and a long answer. The short answer is nobody knows. The long answer involves theories and patterns that have been noticed but in the end the long answer in no better than the short.

Some researchers believe that Fibromyalgia is often as a result of stress or stressful trauma. Many patients site extreme stress levels just before the condition started. I think once Fibromyalgia sets in it is often very difficult to differentiate with stress caused by the condition and stress separate from the condition. Fibromyalgia has a negative impact on most areas of people’s lives, they find that because of the symptoms a normal life is much harder to achieve compared to those without such a condition.

Whatever the cause there is a very real and common cycle of pain, fatigue and sleep problems with Fibromyalgia and people often find that better control of one aspect can lead to benefits in others. Unfortunately until the causes of Fibromyalgia are found we have no other choice but to seek methods of managing the symptoms that come with it and strive for a better quality of life.

Fibromyalgia Theories

There are an abundance of theories about Fibromyalgia that can be found when researching the condition. Some are in my mind more plausible than others although when it comes to measuring the actual benefit they have had on treatments for patients things become rather hazy. This isn’t necessarily a reflection on the accuracy of these theories if you believe Fibromyalgia is simply a category of symptom types or in fact a symptom in itself of an unknown condition. I think very much like this and personally believe this is why Fibromyalgia patients present with different symptoms and respond to different treatments. For information I have listed various theories on this page to assist anyone looking at the variety of different theories out there, I will however say that patients reading this list should keep their expectations under control when it comes to how these theories may benefit you. I’m not sure there are any “miracles” or “huge advances in understanding” within this list.

Hidden sensory system within the skin

This is one of my favoured theories and something I have been keeping an eye on now for quite a few years. Its rather complicated but starts with research into how patients with no pain sensation still can feel movement and heat etc. Researchers then claimed to find a hidden sensory system within the skin that was responsible for these sensations and hypothesised that it was this sensory system that could be dysfunctioning in people with Fibromyalgia. Now they have pioneered a technique to reveal this system and they claim to have evidence that these sensors are far more abundant in the skin of Fibromyalgia patients. As with a lot of research finding out who is behind this exactly can take a but of work and I have found financial connections with two drug companies, however they do not hide this fact and does not mean there is anything wrong with this very interesting theory by any means.

You can read more about this theory in an article I wrote on the subject here

Spinal Chord pain malfunction and overloading

One theory is that Fibromyalgia may be a malfunction in the way the body processes pain in the spinal chord. This results in the central nervous system remembering pain feelings for a longer time than usual. Normally pain subsides after stimuli is stopped however with Fibromyalgia it seems to linger for longer than usual and when a stimuli is applied again it results in an increased pain response. This comes from a study at Gerorgetown University Medical Centre in America where brain scans were used and patients with Fibromyalgia were tested against patients without fibromyalgia and was published in Arthritis & Rheumatism in May 2002. Further clinical studies have shown that for those with chronic pain the spinal cord becomes overloaded with input. This makes it oversensitive to pain signals and results in an overreaction or amplification of pain. With Fibromyalgia the whole body seems to be oversensitive to pain and the body’s pain threshold.

More about this theory

Substance P

Another theory is that research found those with Fibromyalgia were found to have double the levels of a brain chemical called substance P, a neuropeptide involved in pain signals. This chemical helps the nervous system cells send messages to each other about pain. It is thought that when substance P levels are higher they produce higher levels of pain.

More about this theory

Low Serotonin & abnormal transport of serum tryptophan

A connection to serotonin is another theory as research indicates hypersensitivity can be caused by low levels of serotonin. lower levels of serotonin also cause a lower pain threshold and disturbed sleep. Again this theory has its foundations in clinical findings of abnormal transport of serum tryptophan which is a precursor to serotonin. Many of the more popular medications for Fibromyalgia work by slowing down the body’s reuptake of serotonin such as Amitriptyline and Duloxetine.

More about this theory

A build up of Lactic Acid causing muscle tears and free radical increase

The author of this theory suspects that in fibromyalgia there is an inappropriate switch from aerobic mitochondrial production of energy (via oxidative phosphorylation) to glycolysis (very inefficient anaerobic production of energy, not requiring oxygen, but with a large build up of lactic acid). Lactic acid in the short term causes immediate muscle pain. Normally this is remedied by the person slowing down or stopping because of that pain, cells switch back into aerobic metabolism and the lactic acid is quickly cleared away and got rid of. All athletes know that when they stop running the horrible painful sensation in their legs will be gone within a few seconds or minutes.
This does not happen in fibromyalgia because the sufferer can’t make ATP quickly enough to shunt lactic acid back to acetate (via the Cori Cycle) and the sufferer is completely pole axed by ongoing lactic acid burn with inability to move and possibly secondary damage from lactic acid which, for example, is good at breaking down the collagen matrix which holds cells together. That is to say, the lactic acid may cause microscopic muscle tears, which would present as local areas of soreness and would trigger a process of healing and repair by the immune system. There would also be excessive release of free radicals as the immune system repairs. This may well cause further muscle damage in people with poor antioxidant system. This is a disease amplifying process. Some sufferers find B12 helpful, possibly because it is acting as a scavenger of free radicals.

More about this theory

Chronic fatigue syndrome is the symptom caused by mitochondrial failure

This theory was developed with CFS/ME in mind however as I have found out over the years there isn’t much difference between this and Fibromyalgia or FMS. It often depends on the doctor making the diagnosis, family history, the route to patient takes to diagnosis and how a patient describes and prioritises their symptom list. This theory is about mitochondrial failure, the job of mitochondria is to supply energy in the form of ATP (adenosine triphosphate). This is the universal currency of energy. It can be used for all sorts of biochemical jobs from muscle contraction to hormone production. When mitochondria fail, this results in poor supply of ATP, so cells go slow because they do not have the energy supply to function at a normal speed. This means that all bodily functions go slow.

More about this theory

A neuro-endocrine dysfunction of the Autonomic Nervous System (ANS)

This theory is based on a breakdown if the Autonomic Nervous System (ANS) due to stress upon it that could be caused by psychological and physiological stress. The ANS regulates many important biological functions, such as heart rate, blood pressure, respirations, and bowel function. This particular theory is promoted on the Internet by Dan Neuffer under the title “CFS unravelled” and is doing the rounds on twitter. He delivers his theory in three video presentations available on his website, normally visitors will receive a link to these videos after exchanging your email address for them and he employs similar e-marketing strategy on the website and in this delivery. He claims this theory explains the variety of symptoms different patients present with and why different treatments work with different people. He is by no means alone with similar theories citing ANS dysfunction and various doctors have published similar work.

More about this theory (outside of CFS Unravelled)

Why is it important for us to know what causes Fibromyalgia?

I recently looked at this question in detail in this article as it is important to remember “why” we really do need to find the answer to this question. I believe it is far deeper than simply “so we can treat it” and some of the issues arising from not knowing the answer are not always obvious and often misunderstood by those without the condition, in particular friends and family members. I also hope this article could be used to explain some of the frustrations that occur within these relationship between the patient and the friend or family member. So, read it now.