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Fibromyalgia Basics

What is Fibromyalgia?

Fibro cartoon what fibromyalgia is like because it changes all the body's controls

Invisible, unpredictable, frustrating, and oftentimes torturous sums up fibromyalgia. The painful, diffuse symptoms have no boundaries and the disease robs you of restful sleep. You wake up each morning feeling like the fibromyalgia monster punched you around all night. Your muscles are stiff, your brain is dead, and you’re exhausted before the day begins.

Fibromyalgia affects every system in your body, but lab tests don’t explain your long list of symptoms. You look normal and feel awful; living with the disease is a constant struggle that others can’t see.

Feels Like the Flu

Most people with fibromyalgia describe it as bad case of the flu that never goes away. Scientifically, evidence supports the concept that the disease resembles a chronic viral infection.

When viruses invade your body, the immune cells in your central nervous system go ballistic to protect your brain. In doing so, your neurons send pain alarms out to your muscles and other tissues. This widespread achiness causes fatigue, trouble concentrating (brain fog), and insomnia. It’s the very thing that lands people in bed when an infectious agent invades their body.

Research shows that these immune cells are on the rampage in people with fibromyalgia. But instead of causing symptoms for only a day or two, these cells remain in the “enraged” mode. This produces a chronic state of flu-like symptoms.

Brain imaging studies funded by AFSA document the hyperactivity of these immune cells in fibromyalgia patients.<sup>1 </sup>However, blood tests fail to detect this activity because these cells hide out in the central nervous system.

Alters Body Functions

Doctors often tell fibromyalgia patients that there is nothing wrong with them because tests do not reveal a tissue-destroying process. This is insulting given the multitude of symptoms. Yet, the absence of tissue destruction should be viewed with optimism. It may mean that researchers can reverse the processes causing this condition.

Instead of being a destructive disease, fibromyalgia impairs the way your brain and spinal cord operate. In turn, this dysfunction spills over into problems with regulating all of your organ systems, such as your digestive tract, your natural stress response mechanisms, and your cardiovascular system, to name a few.

Fibromyalgia is like having a foreign invader inside your body who changes all your control settings so nothing works correctly. Your mind can’t focus, your digestion is fussy, the blood flow to your muscles is impaired, the slightest touch hurts, bright lights and other sensory signals are overwhelming, your coordination is off, and your head constantly pounds. The long list of symptoms makes you feel twenty years older … and then some.

What Causes Fibromyalgia?

What sets the fibromyalgia wheels in motion? Genetics plays a big role. Blood relatives of patients are eight times more likely to develop the condition. Genetic predisposition coupled with exposure to a triggering event causes the symptoms to surface. The most common triggers are infections, injuries, development of another disease, prolonged stress, or trauma. These events activate the immune cells in the nervous system and impair the body’s ability to fight pain. However, it’s still unclear how this leads to fibro.

Views on what causes fibromyalgia constantly change. Initially, researchers thought muscle inflammation caused it, but studies quickly dispelled this myth. Next, it was viewed as a disease of the central nervous system. While this is still partly true, injecting mice with serum and other fluids from fibromyalgia patients causes a rapid onset of pain. This shows that cells outside the nervous system also contribute to the disease. 

Today, fibromyalgia is more than a central nervous system disease. Your digestive, metabolic, and immune systems collude with the control centers in your brain to cause the disease. And despite its impact on all your body systems, fibromyalgia lurks in the shadows, undetectable by standard laboratory tests.

Illustration diagram showing the processes that occur in fibromyalgia

Researchers are uncovering more about what causes fibromyalgia. Each new discovery reveals the increasing complexity of the condition. We hope that advances in research will lead to better treatments. In fact, the idea that it can be transferred from patients to mice is a game-changer. See articles on Autoimmune Disease and Targeting the Gut for more details. With additional research funding from AFSA, we can develop more effective therapies soon.

Diagnostic Challenges

Doctors diagnose fibromyalgia by the presence of widespread pain, as there is no blood test for it. Although the medical community uses this method to identify people with this condition, patients deserve more. Lab markers lend credibility to diseases, but we need research dollars to develop them. Despite the 25 percent disability rate, government funds studies on fibromyalgia at only 15 cents per patient.

So, what is fibromyalgia? It affects every system in the body to cause widespread pain and profound fatigue, but no lab test can prove its existence. The symptoms of resemble a bad flu; they are mind-boggling and difficult to manage. Patients face a credibility dilemma in the doctor’s office, as well as with their family and friends. While researchers are making progress on fibromyalgia, inadequate funding seriously hampers it.

Fibromyalgia Quick Facts

    • Affects 3 to 5 percent of the general population2
    • Occurs in people of all ages, including children
    • Men develop fibromyalgia too, although more women are diagnosed with it
    • Symptoms are chronic but fluctuate throughout the day
    • Roughly one-quarter of fibromyalgia patients are work-disabled3
    • Three drugs are FDA-approved for fibromyalgia, but Europe does not endorse them due to low efficacy and high side effects

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1. Mueller C, Younger JW, et al.  PAIN 164(10)2285-95, 2023. Free Journal Report
2. Branco JC, et al. Semin Arthritis Rheum 39(6):448-53, 2010. Abstract
3. Fitzcharles MA, et al. J Rheumatol 43(5)931-6, 2016. Abstract