Causes of fibromyalgia

The causes of fibromyalgia are unknown, but in recent decades, statistically confirmed data have been accumulated that set certain vectors in the direction of studying fibromyalgia.

FMS - fibromyalgia exists in two forms approved by the American Association of Rheumatologists.

Primary fibromyalgia is one of two clinical forms of a syndromic, poorly studied disease characterized by muscular-fascial pains and a depressive condition. Primary fibromyalgia is formed for reasons not yet established and not concretized medicine, however, as a disease is considered an independent nosological unit, unlike another form of FMS secondary, which is formed against the background of the underlying pathology.

The names of primary fibromyalgia may vary and differ from each other, since there is still no consensus in the world of medicine about etiologic causes. However, since 1977, thanks to the developments of Smith and Moldovski, the diagnostic criteria for fibromyalgia began to be systematized, which were later refined twice - in 1981 (Yunus criteria) and finally in 1990 by the American College of Rheumatologists. Also European and American doctors put forward concepts of the origin of the disease, which do not contradict, but only complement each other. The difference is only in the designation of the etiological factors related to the forms of fibromyalgia: primary fibromyalgia has really unspecified causes, secondary fibromyalgia is considered more studied and the underlying causes provoking it are much easier to establish.

[1], [2], [3], [4], [5], [6]

Here are several versions of the versions and concepts of the cause of fibromyalgia

1. According to the group of Israeli rheumatologists, for whom the topic of clinical observation has become fibromyalgia, its causes lie in post-traumatic factors. Trauma is not only an accident, an accident, but also a serious illness, which damages the central nervous system. Since 1997, rheumatologists have observed patients with cervical spinal trauma and have established a clear relationship between these injuries and the "start" of myofascial syndrome. Most often fibromyalgia of the cause had, concerning damage to the cervical spine or head trauma. This version, of course, refers to the study of the etiology of secondary fibromyalgia. 
2. Colleagues of Israeli doctors, specialists from the American University of Alabama, are convinced that not all cases of fibromyalgia are associated with a post-traumatic trigger. They found that the cause fibromyalgia can also be of a hereditary nature, since the family pattern of muscle pain formation was traced in 45-50% of the patients studied. Thus, the work of American doctors provide the basis for the work of geneticists and, the possibility of getting an answer to the question of why primary fibromyalgia develops. 
3. Some US scientists tend to adhere to the theory of manifestation of fibromyalgic symptoms as a consequence of compression of the spinal column. These doctors also propose to consider and more closely study the infectious cause of fibromyalgia and the appearance of myofascial syndrome. 
4. There is a version of European researchers, according to which the cause of fibromyalgia has in the sphere of neurotransmitter disorders, in particular - the lack of serotonin and, as a consequence, the manifestation of hypersensitivity to the pain symptom. A similar theory is under experimental study, but over the past five years, since 2008, information has already been accumulated on the effect of serotonin deficiency on allodynia (increased perception of pain). This concept is directly related to a form of the disease, such as primary fibromyalgia. 
5. Doctors of the Medical University of Michigan put forward a theory about the impact on the development of fibromyalgia from the neuroendocrine system. Unlike European colleagues, their attention was drawn not to serotonin, but to dopamine, histamine, endorphin, noradrenaline and gammaaminobutyric acid. The study group of patients with fibromyalgic pains showed insufficient production of necessary hormones from the hypothalamic-pituitary and adrenal glands. Thus, Michigan scientists are inclined to the version of the stressful origin of fibromyalgia. Indeed, muscle pains increase after psychoemotional shocks, this is confirmed by scientists from the state of Oregon who found a low level of somatotropin in patients with fibromyalgia. Somatotropin - a polypeptide hormone, which is necessary in childhood for growth of the body. In adults, fibromyalgia, the causes of which continue to be studied, develops mainly in people older than 20 years, the somatotropin is responsible for anabolic resources, and also affects the activity of cognitive, cognitive functions of the brain.
6. A group of Mexican scientists revealed a direct dependence of the development of fibromyalgia and the presence of hypothyroidism in female patients. It was established that fibromyalgia most often affects women, the percentage ratio to male patients is 65/35%. According to Mexican endocrinologists, it is the insufficient amount of thyroid hormones that provokes changes in the central nervous system, which leads to muscle pain and other symptoms of fibromyalgia. 
7. The cause of fibromyalgia, according to one version, may have chronic fatigue syndrome. This is also a poorly understood disease, but many doctors in Europe, Asia and the US are increasingly inclined to this option. In countries where FMS - fibromyalgia is not isolated in a separate nosological unit, it is considered one of the leading symptoms in the diagnosis of CFS. 
8. The version of insomnia as a provoking factor that causes fibromyalgia has ceased to be regarded as objectively confirmed over the past five years. Nevertheless, there are statistical data on the relationship between low level of somatotropin, which should be normal in the phase of deep sleep, and the development of fibromyalgia.

According to some sources, the pathophysiologic development of fibromyalgia occurs step-by-step, from a trigger-stress, trauma or acute infectious disease, to the formation of persistent diffuse muscle pains and depression.

Fibromyalgia causes in its anamnestic manifestation demonstrates the following: 

• The person is in a state of chronic stress, constant mobilization and tension of the nervous system, obviously, acts as a trigger for the development of fascial muscle pains, especially for impressionable, nervous people. In people with an adequately tuned nervous system, stress, even very acute, causes active resistance and encourages one or another action. In people with a weak nervous system, the stressful situation only depletes the already depleted and weak mobilization resources. The body compensates for the mobilization of muscle tissue, which also does not cope with the load. There are pains, the endocrine immune and nervous systems are depleted even more. These factors directly affect the form of the disease, such as primary fibromyalgia. 
• A person (most often a woman) suffers from a latent form of hypothyroidism, which is not manifested by obvious symptoms and, therefore, is not diagnosed in a timely manner. Developing hypothyroidism provokes a malfunction of the central nervous system.

Subclinical form of the disease also provokes depletion of the immune system, which can lead to infection with such agents as: 

1. Herpes viruses are types 1, 2, 6.
2. VEB is a herpetic virus of the 4th type, the Epstein-Barr virus. 
3. Cytomegalovirus. 
4. A herpetic virus of the third type or VVZ is a Varicella-Zoster virus that causes chickenpox or herpes zoster. 
5. Mycoplasma. 
6. Chlamydia. 
7. Toxoplasma. 
8. Streptococcus.

Fibromyalgia causes also infectious nature. If the organism is infected with the above viruses or bacteria, the weakened immune system is not able to respond adequately to the invasion of the infection, and begins to attack the secreted antibodies own tissues - tendons and muscles. Typical fibromyalgic pains appear.

Among the factors provoking FMS - fibromyalgic syndrome, of course, there are certain conditions, diseases that are already systematized and collected into etiological groups. Among them, doctors call the following: 

1. Chronic or acute stress. 
2. Injuries. 
3. Violation of the hormonal balance, in women often it is associated with menopause. 
4. Neurological disorders, diseases that refer to "small" psychiatry. 
5. Immunodeficiency. 
6. Endocrine pathologies.
7. Infectious diseases, mainly TORCH-infections. 
8. Physical overload. 
9. An hereditary factor, which may result in primary fibromyalgia.

Also, in a statistical sense, it was possible to find out what causes fibromyalgia in this way: 

• Children and adolescents - from 9 to 15 years in 30% of cases of all diagnosed syndromes. Most often, children are diagnosed with primary fibromyalgia. 
• Traumatic injuries - in 25% of cases from the total number of diagnosed patients, 40% of all traumatic causes account for the damage to the cervical spine, 30% for the trauma of the lumbar spine. 
• The onset of the disease with diffuse pain symptoms in the legs is 65%. 
• Fibromyalgia in men (55-65%) of all cases is associated with physical overloads, sports injuries.

Summarizing the diversity of the etiological variants resulting in the formation of both primary fibromyalgia and the secondary form, they can be systematized into the following categories: 

• The primary cause in the pathogenesis of the disease is a change in the sequence of perception of pain. 
• The primary cause in the pathogenesis of fibromyalgia is a focus of pain localized at trigger points, which is subsequently generalized to typical symptoms of fibromyalgia-diffuse pain, sleep disturbance, depression, and decreased physical activity. 
• There is also a concept describing the imbalance of neurochemical communication, in particular the insufficiency of the level of serotonin, which, according to the authors of the version, provokes the formation of fibromyalgic syndrome. There is a theory claiming that primary fibromyalgia is a consequence of genetic disorders and is inherited. 
• The rest of the concepts, which include the traumatic factor, the endocrine and infectious nature of the disease, relate to the second form of FMS, secondary fibromyalgia.

More and more scientists and doctors are inclined to the version claiming that the cause fibromyalgia has in the sphere of disturbance of mitochondrial connections and serotonin metabolism. The efforts of rheumatologists, neuropathologists, immunologists and endocrinologists today are aimed at integrating the received diverse and sometimes contradictory information into a single system that will help to find out why the fibromyalgia of the cause is still "a secret with seven seals"