Fibromyalgia - an introduction

Posted on

23.12.2024

Edited on

26.12.2024

Reading time:

5 minutes

Contents

Fibromyalgia in the human body

Mechanisms and progression

Causes

Summary

Fibromyalgia is a complex pain disorder. It is characterized by persistent muscle and joint pain and increased sensitivity to pain, but can also be accompanied by a variety of other physical and psychological complaints. Fibromyalgia is a chronic pain disorder that is the subject of ongoing scientific research.

This article provides an introductory overview of the disorder, describes the underlying mechanisms and highlights possible causes and risk factors.

Fibromyalgia in the human body

Fibromyalgia syndrome (FMS) is a chronic pain disorder that is classified as a disease of the musculoskeletal system and connective tissue. Fibromyalgia literally means muscle-fiber pain.

Fibromyalgia is often categorized as a central sensitivity disorder, as it is thought to be caused by impaired pain processing in the brain and spinal cord.

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Chronic pain lasting at least three months in several regions of the body is the main symptom of fibromyalgia syndrome. However, this pain is not triggered by an injury. Instead, the function of the central nervous system and pain processing in the body is impaired.

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The exact processes that lead to the pronounced sensitivity to pain are still being scientifically investigated. Researchers assume that a disorder in central pain processing leads to increased sensitivity to pain stimuli [2,3]. As a result, the brain perceives pain without the presence of a damaging stimulus. The pain threshold also falls, which means that stimuli that are actually harmless are perceived as painful: A normal touch, cold or slight pressure sensations can be perceived as unpleasantly intense.

Fibromyalgia syndrome can also be accompanied by sleep problems, fatigue, hypersensitivity to stimuli (e.g. sensitive eyes, sensitivity to touch, sound and smell) and psychological complaints such as nervousness, inner restlessness, depression and loss of motivation.

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Fibromyalgia is a chronic disease. As such, it is currently incurable. Treatment is aimed at alleviating the symptoms and trying to improve the quality of life of those affected.

In western industrialized nations, around 2% of the population is affected by fibromyalgia. The majority of those affected are women between the ages of 40-60. However, younger women, men of all ages, children and adolescents can also suffer from FMS.

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Mechanisms and progression

An important feature of fibromyalgia is the increased sensitivity to pain and the associated disruption of pain processing in the brain and spinal cord. This mechanism leads to so-called central sensitization, in which pain stimuli are perceived more strongly.

The central mechanisms in fibromyalgia comprise two main aspects:

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Central sensitization

The central nervous system reacts hypersensitively to pain stimuli. As a result, even light touch or other minor stimuli can be perceived as painful [3,4].

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Dysregulation of neurotransmitters

Signal transmission and processing in the brain is influenced by dysregulation of neurotransmitters such as serotonin and noradrenaline. These neurotransmitters are significantly involved in pain regulation and could play a role in the increased sensitivity to pain and the mood swings of those affected [5-8].

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The course of the disease is individual. However, most patients have a permanently increased sensitivity to pain. Many patients also suffer from additional symptoms such as sleep disorders, fatigue and cognitive impairment. Cognitive impairment is also known as fibro-fog.

Fibromyalgia is a serious illness that can significantly reduce the quality of life of those affected. However, FMS does not affect life expectancy.

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Causes

The exact causes of fibromyalgia are not yet fully understood. However, researchers suspect a combination of several factors that could influence the disease. These include genetic predispositions as well as environmental and lifestyle factors.

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Genetic predisposition

Fibromyalgia tends to run in families, which indicates a genetic susceptibility. According to scientific studies, certain gene variants that influence pain regulation affect the risk of developing fibromyalgia [9-12].

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Environmental and lifestyle factors

Various external factors also appear to play a role [13-15]. These include:

Stress and psychological strain: Persistent stressful situations or psychological distress often precede a fibromyalgia diagnosis. Chronic stress can increase sensitivity to pain and worsen the course of the disease [16-18].
Severe infections or injuries: In some cases, patients develop the first symptoms of fibromyalgia after infectious diseases or physical trauma. These events could serve as triggers for central sensitization [14, 19-20].
Chronic diseases: Fibromyalgia syndrome can also develop as a result of another chronic illness, such as rheumatoid arthritis or spondyloarthritis [24].
Sleep disorders: Sleep disturbances are a common concomitant symptom of fibromyalgia and appear to interact with pain sensitivity [21-23].

Fibromyalgia is a chronic pain disorder caused by impaired pain processing in the central nervous system. It affects a variety of physical and psychological symptoms that can severely restrict the daily lives of those affected. The causes are not yet fully understood, but a combination of genetic, biological and psychosocial factors play a role. As there is currently no cure for fibromyalgia, treatment is aimed at alleviating symptoms and improving quality of life.

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[24] Duffield, Stephen J et al. “Concomitant Fibromyalgia Complicating Chronic Inflammatory Arthritis: A Systematic Review and Meta-Analysis.” Rheumatology (Oxford, England) Vol. 57.8 (2018): 1453-1460. doi:10.1093/rheumatology/key112

Fibromyalgia - an introduction

Fibromyalgia in the human body