It’s still a controversial diagnosis: fibromyalgia syndrome, or FMS, is something which often leaves the medical community very divided. While the diagnosis has become more respectable in the United States in the last ten years, FMS is still heavily criticised by many doctors. The main reason for this is because FMS does not correspond to the typical medical model of an illness as most people understand it – the causes are not well understood, the symptoms differ widely from patient to patient, and there is no definable cure.
With such unclear boundaries, it’s no wonder that fibromyalgia is often dismissed as something which isn’t quite medically sound. This, however, could not be further from the truth. Rheumatologists have spent the last 30 years making leaps and bounds in their FMS related discoveries, and while the science still leaves more questions than answers, these days there is far more that we understand about what could cause fibromyalgia.
The first thing to understand about FMS, is that there is not necessarily one clear way that the illness can manifest itself. In fact, there are four primary groupings of FMS sufferers. Müller, Schneider and Stratz define these groupings as follows:
– “extreme sensitivity to pain but no associated psychiatric conditions” (suggested use of drugs which inhibit the 5-HT3 receptor)
– “fibromyalgia and comorbid, pain-related depression” (possibly responsive to anti-depressants)
– “depression with concomitant fibromyalgia syndrome” (possibly unresponsive to anti-depressants)
– “fibromyalgia due to somatization” (suggested treatment of psychotherapy)
With each of these groupings, there are different likelihoods of what could cause that particular sufferer’s FMS. As suggested above, there isn’t necessarily one actual cause for FMS, but there are at present several theories as to possible causes.
A high number of FMS suffers also have problems with their sleeping patterns, and it’s believed that this is no coincidence. Not being able to get enough deep sleep every night leads to further problems with muscles and nerves, which only serves to continually aggravate typical FMS aches and pains. This pain, in turn, makes sleep even harder to come by, which ultimately means that the muscles are unable to heal themselves properly at night. This results in an endless vicious cycle of sleep disturbances and continued pain.
Injury and muscle trauma
Any injury to the spinal column or neck can have lasting repercussions and lead to serious problems for the functioning of the Central Nervous System (CNS). Having injured the CNS, an individual might find that they have an increased sensitivity to pain or record more sleep disturbances. Something as simple as whiplash from a car accident can have a lasting impact on the human body.
This is another slightly controversial area, but it has been reported that certain aspects of an individual’s lifestyle may impact upon how their development of fibromyalgia progresses. What is known is that certain factors can either aggravate or serve as a precursor to fibromyalgia. Things such as stress, depression, posttraumatic stress disorder, chronic fatigue syndrome or irritable bowel syndrome (IBS) are often comorbid with FMS, and therefore sometimes are considered to have a possible hand to play in causing the syndrome. Other lifestyle factors like obesity, smoking and a lack of physical activity can also precipitate an individual developing FMS.
Immune system abnormalities
One of the lesser considered factors, a compromised immune system, can lead to many health problems and can also cause the development of fibromyalgia. Usually, such a diagnosis is attributed to an over-active immune system which, in attempting to fight bacterial infections, has begun to attack the body itself.
It has been hypothesised that there is a high genetic link between FMS sufferers. Should one parent have FMS, the chances of a child inheriting the syndrome are that much greater. FMS is often also found in other members of the family, with siblings also having a high likelihood of sharing the syndrome.
Autonomic Nervous System Dysfunction
One of the more recent discoveries is that FMS may be caused by problems with the brain’s Autonomic Nervous System (ANS). The ANS is responsible for several bodily functions including digestion, metabolism and how we react to stress. Developmental issues with hormones or the neurotransmitters in the ANS can lead to the development of FMS.
With all of these possible causes, the science of FMS is often thrown into doubt. While it is understandably frustrating that there could be so many reasons behind the cause of your chronic pain, know that there are many people in a similar position. Also, know that there is plenty that we do yet know about fibromyalgia – such as the fact that more women than men suffer from FMS, that many only begin to show symptoms after an injury or sustained period of illness, and the fact that there is a high genetic disposition behind the syndrome. All of these pieces of information help paint a clearer picture of who suffers from FMS, when in life the symptoms begin to manifest and what the possible causes may be.
With each passing day, there are more and more answers which become available. In the last ten years, research has progressed in leaps and bounds, and while there is no cure in sight, the vast plethora of information already available means that there are already plenty of treatment options available at present. Because we know how widely the symptoms differ, we understand now how widely the treatment options must differ also. Speak to your doctor about a referral to a qualified rheumatologist with experience treating FMS and you’ll be able to get some answers about what in particular is happening with your body.