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Home > Pain Management > Possible Causes and Risk Factors for Fibromyalgia

Possible Causes and Risk Factors for Fibromyalgia

December 28, 2022
9 min read
By Dr. Arif Maghribi Khan, MBBS, MD | Mental Health Counselor

In this article:

  • Causes and Risk Factors of Fibromyalgia
  • Is Fibromyalgia a Mental Disorder or Somatic Disorder?
  • How Does Fibromyalgia Affect Mental Health?
  • Most-Asked Questions About Fibromyalgia
  • Final Word

Fibromyalgia is a health issue that is associated with musculoskeletal pain and other symptoms. It is characterized by chronic and widespread pain in multiple points in the body with tenderness.

causes and risk factors for fibromyalgia

Fibromyalgia affects your nervous system and causes pain signals to get amplified. General symptoms of fibromyalgia include: (1)

  • Fatigue
  • Insomnia
  • Mood swings
  • Difficulty remembering
  • Headache
  • Irritable bowel syndrome (IBS)
  • Anxiety
  • Depression

The symptoms of fibromyalgia usually occur after a trauma or after you had undergone a surgical procedure. It can also be from mental stress. Sometimes, if an event does not trigger these symptoms, they may accumulate over time.

The pain associated with fibromyalgia can be very intense or mildly intense; it varies from person to person. Also, the frequency of experiencing pain can vary as well.

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But one thing is for sure – the characteristic pain of fibromyalgia is a shooting muscular pain that is chronic in nature. (2)

Causes and Risk Factors of Fibromyalgia

The top causes and risk factors of fibromyalgia include the following.

1. Genetics

Genetics plays a big role in the development of fibromyalgia.

People who have a family history of fibromyalgia tend to be more susceptible to it. Such people also have other neurological symptoms that are associated with fibromyalgia, which include mood swings and increased pain sensitivity. (3)

2. Gender

women are more prone to fibromyalgia than men

Research has shown that women are more prone to suffering from fibromyalgia than men. The majority of the patients who have been diagnosed with fibromyalgia are women.

This does not mean that men cannot suffer from this issue. However, the symptoms that occur in men are lesser in severity and frequency than those in women. (4)

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3. Improper sleep schedule

An electroencephalogram (EEG) shows the electric activity of the brain. EEG results of people with fibromyalgia show abnormal alpha wave activity that is associated with decreased sleep and increased wakefulness. This points toward the possible role of sleep disturbances in fibromyalgia.

Those who are unable to sleep properly at night tend to suffer from increased pain in the case of fibromyalgia. (5)

4. Other diseases

If a person suffers from the following disorders or issues, then they may have an increased risk of fibromyalgia: (6)(7)

  • Rheumatoid arthritis
  • Psoriatic arthritis
  • Sjogren’s syndrome
  • Lupus
  • Spondylitis
  • Depression

5. Physical and emotional trauma

suffering from physical accident/trauma can be risk factor for fibromyalgia

Suffering from a physical accident or trauma can be a serious risk factor for fibromyalgia. Research supports that accidents significantly increase the tendency to suffer from fibromyalgia.

Examples of physical trauma that can lead to fibromyalgia include: (8)

  • Motor vehicle accident
  • Work injury
  • Surgery
  • Sports injury

Even any kind of mental trauma can increase the risk of fibromyalgia. If a child suffers from any kind of emotional abuse during childhood, it can trigger fibromyalgia in adulthood. (9)

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Is Fibromyalgia a Mental Disorder or Somatic Disorder?

Fibromyalgia is associated with higher chances of mental distress including depression. There have been talks of classifying fibromyalgia as a mental disorder because of the mental toll it takes on a person.

A study done for the same showed how the majority of people who suffer from fibromyalgia experienced psychological disorders. This goes to show how fibromyalgia may be categorized as a mental disorder in many cases. (10)

How Does Fibromyalgia Affect Mental Health?

how does fibromyalgia affect mental health?

Those who suffer from fibromyalgia are three times more prone to mental illnesses from depression when compared to the rest of the people. This is why depression is regarded as a symptom of fibromyalgia, according to the American College of Rheumatology.

However, it is not known if depression is triggered by fibromyalgia or if it is the other way around, meaning people who suffer from fibromyalgia have an increased risk of depression or if depression is merely just a part of this disease. (11)

Whatever may be the connection, it’s evident that people with fibromyalgia frequently suffer from depression and various other mental health issues that greatly impact their quality of life.

A 2019 paper published in the journal Psychology Research and Behavior Management demonstrated that, in addition to depression, (11) various other psychological conditions are linked with fibromyalgia, including:

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  • Anxiety
  • Borderline personality disorder
  • Obsessive-compulsive disorder
  • Post-traumatic stress disorder (PTSD)
  • Suicidal tendency

Some other psychological symptoms include:

  • Perfectionism
  • Neurotic tendencies
  • Increased levels of stress
  • Episodes of anger

People who suffer from fibromyalgia are also seen to have:

  • Low self-esteem
  • Poor body image
  • Difficulty in interpersonal relationships
  • Challenges in socializing
  • A hard time doing everyday tasks

Most-Asked Questions About Fibromyalgia

Why is fibromyalgia more common in women than in men?

Fibromyalgia is more common in women because of various reasons, some of which include: (12)

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  • Increased anxiety levels
  • Altered pain response
  • Hormonal changes due to the menstrual cycle
  • Maladaptive coping strategies
  • Increased levels of depression

How do I know if my pain is fibromyalgia?

how to check if the pain is from fibromyalgia?

Fibromyalgia can be characterized by certain criteria including: (13)

  • Suffering from severe pain in different parts of your body, 3–6 areas
  • Suffering from mild pain in 7 or more areas of the body
  • No improvement in symptoms for more than 3 months
  • No underlying cause or reason for your symptoms

The preliminary diagnostic criteria by the American College of Rheumatology may be used to support a clinical diagnosis of fibromyalgia. These criteria do not need palpation of tender points. (14)

As per these criteria, patients’ conditions are evaluated by the overall pain index that divides the body into 19 regions and a score is given to the number of regions reported to be painful.

A symptom severity score evaluates the severity of tiredness, poor sleep quality, and cognitive symptoms. A cutoff score of 12–13 was statistically significant in differentiating those who fulfilled the ACR 2010 criteria and those who did not.

Can I suddenly develop fibromyalgia?

Symptoms related to fibromyalgia can develop suddenly after you suffer from a physical injury, trauma, illness, or psychological stress. In other cases, symptoms of fibromyalgia develop gradually and may not be so sudden.

Who are at most risk of fibromyalgia?

Some people may be more at risk of fibromyalgia than others. These include those who suffer from: (15)

  • Rheumatoid arthritis
  • Lupus
  • Osteoarthritis
  • Depression and anxiety
  • Back pain
  • Irritable bowel syndrome

What conditions does fibromyalgia tend to coexist with?

Fibromyalgia can be characterized by an increase in certain chemical levels that are associated with the pain signaling pathways in the body. This condition can coexist with: (16)

  • Chronic fatigue syndrome
  • Migraine
  • Interstitial cystitis
  • Temporomandibular joint disorder
  • Postural tachycardia
  • Mental illnesses
  • Rheumatoid arthritis
  • Systemic lupus erythematosus

What are some other symptoms of fibromyalgia?

Other than the commonly observed symptoms, some other symptoms of fibromyalgia can include: (2)

  • Vision problem
  • Urinary issues
  • Weight gain
  • Post-traumatic stress disorder
  • Breathing issues
  • Restless leg syndrome

What is the treatment for fibromyalgia?

Fibromyalgia is a difficult condition to manage. It is always good to seek professional help to tend to this issue and manage its symptoms.

A rheumatologist will be able to assist you to design a treatment plan for your fibromyalgia. The treatment can include: (17)

  • Acupuncture
  • Exercise
  • Chiropractic care
  • Psychotherapy
  • Massaging
  • Cognitive behavioral therapy
  • Medications such as antidepressants, painkillers, and muscle relaxants

Fibromyalgia usually affects which parts of the body?

The areas of the body that get tender due to fibromyalgia include: (2)

  • Collarbone
  • Chest
  • Elbows
  • Knees
  • Neck
  • Shoulders
  • Buttocks
  • Back

Is there any relationship between COVID and fibromyalgia?

is there any relation between COVID and fibromyalgia?

Data indicate that clinical characteristics of fibromyalgia are common in patients who recovered from COVID-19 and also that obesity and the male gender affect the risk of developing post-COVID-19 fibromyalgia. (18)

If you have fibromyalgia, you could be at a greater risk of COVID-19. Furthermore, if you also suffer from an autoimmune disorder such as rheumatoid arthritis or lupus, your chances of having COVID-19 increase even more.

Both the diseases themselves and the drugs given to treat them such as disease-modifying antirheumatic drugs (DMARDs) or corticosteroids can increase your risk of getting infections. (19) This is because the DMARDs and steroids decrease your immune response to make sure your body doesn’t attack your joints and other healthy tissues, which is what happens in autoimmune disorders. (20)

But with a weaker immune system, your body’s defense against infections also gets diminished, and you may not be able to fight off COVID-19 as greatly. If you are taking DMARDs to treat autoimmune disorders, don’t just stop them without your doctor’s advice.

Drugs for fibromyalgia treatment such as antidepressants and antiseizure drugs don’t really affect your immune system or increase your risk of COVID-19. It’s important to keep taking these drugs to avoid flares.

You should, however, get vaccinated against COVID-19 as soon as possible, and even after getting your vaccination, you should continue to follow the CDC’s guidelines to protect yourself from COVID-19:

  • Wear a mask before heading out or when with people.
  • Wash your hands thoroughly with soap and water for a minimum of 20 seconds after coming back home.
  • Avoid touching your nose, mouth, and eyes.
  • Avoid leaving home as much as you can.
  • Maintain a distance of 6 feet from people.
  • Social distancing can keep you away from your loved ones, but remember to stay in touch via phone. Also, online fibromyalgia support groups can be helpful for seeking support and comfort when needed.

Final Word

Fibromyalgia may not be a life-threatening illness, but it can certainly alter your quality of life. Therefore, equipping yourself to cope with this condition and learning to live with it will help you achieve the best possible results. For this, you should speak with your doctor about the best treatment for you.

Other than that, always seek support when required from your loved ones as doing so will make the journey easy for you.

References
  1. Bellato, E., Marini, E., Castoldi, F., Barbasetti, N., Mattei, L., Bonasia, D. E., & Blonna, D. (2012). Fibromyalgia syndrome: Etiology, pathogenesis, diagnosis, and treatment. Pain research and treatment. Retrieved September 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3503476/.
  2. Siracusa, R., Paola, R. D., Cuzzocrea, S., & Impellizzeri, D. (2021, April 9). Fibromyalgia: Pathogenesis, mechanisms, diagnosis and treatment options update. International journal of molecular sciences. Retrieved September 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8068842/.
  3. D’Agnelli, S., Arendt-Nielsen, L., Gerra, M. C., Zatorri, K., Boggiani, L., Baciarello, M., & Bignami, E. (2019). Fibromyalgia: Genetics and epigenetics insights may provide the basis for the development of diagnostic biomarkers. Molecular pain. Retrieved September 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322092/.
  4. MB;, Y. (n.d.). The role of gender in fibromyalgia syndrome. Current rheumatology reports. Retrieved September 26, 2022, from https://pubmed.ncbi.nlm.nih.gov/11286669/.
  5. EH;, C. (n.d.). The role of sleep in pain and fibromyalgia. Nature reviews. Rheumatology. Retrieved September 26, 2022, from https://pubmed.ncbi.nlm.nih.gov/25907704/.
  6. Gist AC; Guymer EK; Eades LE; Leech M; Littlejohn GO; (n.d.). Fibromyalgia remains a significant burden in rheumatoid arthritis patients in Australia. International journal of rheumatic diseases. Retrieved September 26, 2022, from https://pubmed.ncbi.nlm.nih.gov/28296177/.
  7. Wolfe, F., Petri, M., Alarcón, G. S., Goldman, J., Chakravarty, E. F., Katz, R. S., & Karlson, E. W. (2009, January). Fibromyalgia, systemic lupus erythematosus (SLE), and evaluation of SLE Activity. The Journal of rheumatology. Retrieved September 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2944223/.
  8. RH;, W. G. W. P. (n.d.). Post-traumatic fibromyalgia. A long-term follow-up. American journal of physical medicine & rehabilitation. Retrieved September 26, 2022, from https://pubmed.ncbi.nlm.nih.gov/7993614/.
  9. Gündüz, N., Polat, A., Erzincan, E., Turan, H., Sade, I., & Tural, Ü. (2018, February 25). Psychiatric comorbidity and childhood trauma in fibromyalgia syndrome. Turkish journal of physical medicine and rehabilitation. Retrieved September 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6657761/.
  10. Klaus K; Fischer S; Doerr JM; Nater UM; Mewes R; (n.d.). Classifying fibromyalgia syndrome as a mental disorder?-An Ambulatory Assessment Study. International journal of behavioral medicine. Retrieved October 10, 2022, from https://pubmed.ncbi.nlm.nih.gov/27757841/.
  11. Galvez-Sánchez CM, Duschek S, Reyes Del Paso GA. Psychological impact of fibromyalgia: Current perspectives. Psychology research and behavior management. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6386210/. Published February 13, 2019.
  12. Fibromyalgia – statpearls – NCBI bookshelf. (n.d.). Retrieved October 10, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK540974/.
  13. NHS. (n.d.). NHS choices. Retrieved October 10, 2022, from https://www.nhs.uk/conditions/fibromyalgia/diagnosis/
  14. Galvez-Sánchez CM, Reyes Del Paso GA. Diagnostic criteria for fibromyalgia: Critical Review and future perspectives. Journal of clinical medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230253/. Published April 23, 2020.
  15. U.S. Department of Health and Human Services. (2022, April 8). Fibromyalgia. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Retrieved October 10, 2022, from https://www.niams.nih.gov/health-topics/fibromyalgia.
  16. Physicians Postgraduate Press, Inc. (2008). Understanding fibromyalgia and its related disorders. Primary care companion to the Journal of clinical psychiatry. Retrieved September 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292439/.
  17. Kwiatek, R. (2017, October). Treatment of fibromyalgia. Australian prescriber. Retrieved September 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5662432/.
  18. Ursini F, Ciaffi J, Mancarella L, et al. Fibromyalgia: A new facet of the post-covid-19 syndrome spectrum? results from a web-based survey. RMD open. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8384499/. Published August 2021.
  19. Fernandez-Ruiz R, Paredes JL, Niewold TB. Covid-19 in patients with systemic lupus erythematosus: Lessons learned from the inflammatory disease. Translational research: the journal of laboratory and clinical medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7749645/. Published June 2021.
  20. Bodkhe R, Balakrishnan B, Taneja V. The role of microbiome in rheumatoid arthritis treatment. Therapeutic advances in musculoskeletal disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6685117. Published July 30, 2019.
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