It appears that somewhere between two-thirds and three-fourths of those with fibromyalgia first developed the condition during or immediately following a period of great stress. Sometimes that’s a physical stress (such as an auto accident or even what seems at the time like a relatively mild injury) – but most often the stress is psychological or emotional.
How could a stressful life situation cause (or trigger) fibromyalgia?
The connection seems to be that many of these triggering events are associated with an elevated inflammatory response. It’s almost as if some part of the inflammatory response system gets turned on and then never quite turned off.
That doesn’t mean fibromyalgia is caused by inflammation – not as its commonly understood. Fibromyalgia is not like the inflammation of rheumatoid arthritis. It’s not even like the type of inflammation you might have after a bee sting or when sun burned.
Fibromyalgia seems to be related to the acute inflammatory response. That’s not the same as the acute inflammatory event. The difference between the two is profound. It’s like the difference between having too much cholesterol in your blood and having a heart attack. One might lead to the other, eventually, but it doesn’t always.
I think it’s likely that there is some dysfunction in the inflammatory response system. A little too much of ‘something’ going on – something related to inflammation – and probably related to cytokines (inter-cellular messengers of inflammation produced by white blood cells.) Technically, that’s a form of inflammation – but let’s not get technical. There is something out of balance, and whatever it is, it’s not silent like high cholesterol – it’s causing lots of symptoms every day.
If, as I suspect, fibromyalgia relates to immune system dysfunction, then it starts to makes sense why those with fibromyalgia tend to develop ‘regular’ inflammatory conditions (say rheumatoid arthritis, for example,) and why those with ‘regular’ inflammatory conditions like RA tend to develop fibromyalgia. It also makes a lot more sense that those with fibromyalgia have such diverse symptoms. It’s not ‘just’ pain.
I understand that current thinking about fibromyalgia has much to do with changes in the brain, spinal cord, nerves, etc., how they regulate pain, etc. I’m certain those changes are real, and that they account for part of what is going on in fibromyalgia. But maybe that’s not where it starts.
It makes sense to me that immune dysfunction might begin with emotional stress, or a broken leg. – especially since those types of events are known to increase inflammation. And we have lots and lots of examples of ‘inflammation that can’t turn off’ (arthritis, autoimmune disease, etc.) Yes, I can imagine that stress might alter the balance of neurotransmitters. But I’m not sure I see a means by which that imbalance could be maintained – sometimes for decades.
Likewise, I haven’t yet been able to figure out how it might be that changes in brain chemistry could lead to a much higher incidence of rheumatoid arthritis among those with fibromyalgia. I don’t think it could.
And I’m not sure there’s a good explanation of how changes in pain processing could lead to insomnia, fatigue, cognitive dysfunction (fibro fog,) dizziness, anxiety, depression, irritable bowel syndrome, Raynaud’s syndrome, and … Well, and a lot of things.
What do you think?