What Causes Fibromyalgia?

by Karen Lee Richards Patient Advocate

by Karen Lee Richards, ChronicPainConnection Expert

There is still some disagreement among researchers as to the cause of fibromyalgia. There is, however, little disagreement that for the majority of patients, its onset is triggered by some form of trauma. It may be physical trauma to the body in the form of an injury or illness, or it could be an emotional trauma that produces severe, often prolonged, stress. Current research seems to indicate that some people have a genetic predisposition to fibromyalgia, although the symptoms usually do not show up until triggered by one of these traumas.

One theory as to the cause of fibromyalgia that is gaining acceptance is that a trauma or significant stressor turns on an individual's "fight-or-flight" response. Since this response is designed to help the person function in an emergency situation, it usually only lasts a short time and then turns itself off. But when the stress becomes prolonged, the fight-or-flight response gets stuck in the "on" position and the person's body remains in a state of high alert. This results in a loss of stage four sleep, which appears to cause pain amplification throughout the body.

Regardless the trigger, scientific evidence has shown that fibromyalgia patients have very real physical abnormalities, including:

  • Decreased blood flow to specific areas of the brain, particularly the thalamus region, which may help explain the pain sensitivity and cognitive functioning problems fibromyalgia patients experience.

  • High levels of "substance P," a central nervous system neurotransmitter involved in pain processing.

  • Low levels of nerve growth factor.

  • Low levels of somatomedin C, a hormone that promotes bone and muscle growth.

  • Low levels of several neurochemicals: serotonin, norepinephrine, dopamine and cortisol.

  • Low levels of phosphocreatine and adenosine, muscle-cell chemicals.

In the past few years, scientists have made tremendous progress in unraveling the mysteries of this painful illness. They're closer than ever to identifying the definitive fibromyalgia causes. This, in turn, should lead to faster fibromyalgia diagnosis and more effective treatments plans.


Interview with Andrew Holman, M.D., Pacific Rheumatology Associates, Inc. PS; Pacific Rheumatology Research, Inc.; Assistant Clinical Professor of Medicine, University of Washington.

"Ten New Truths About Fibromyalgia," Fibromyalgia AWARE, May-August 2005, 47-49.

Karen Lee Richards
Meet Our Writer
Karen Lee Richards

Karen is the co-founder of the National Fibromyalgia Association. She writes for HealthCentral as a patient expert for Pain Management.