Fibromyalgia is a common and chronic disorder characterized by widespread pain. Doctors define “widespread” as occurring below and above the waist and on both sides of the body.
A patient is diagnosed with fibromyalgia if they have suffered constant pain for at least three months. Other symptoms of fibromyalgia include fatigue and “fibro fog.” The latter describes the difficulty that many patients have with concentrating and paying attention to various tasks.
Fibromyalgia can be accompanied by other painful conditions like migraines, irritable bowel syndrome, temporomandibular joint disorders, and interstitial cystitis (painful bladder syndrome).
Fibromyalgia Risk Factors
Researchers aren’t quite sure what causes fibromyalgia. Some have suggested that it might be a central sensitization disorder. That could mean that the nerve cells in the central nervous system are abnormally sensitive, or it could mean that the inhibitory systems that are supposed to help control the processing of pain signals don’t work as effectively as they should.
Scientists have, however, identified a variety of risk factors that increase your chances of developing fibromyalgia. Fibromyalgia risk factors include the following:
Gender
You are far more likely to develop fibromyalgia if you’re female. Roughly speaking, women are about nine times more likely to develop fibromyalgia than are men. Researchers aren’t sure why this is the case, but they believe sex hormones may be involved.
Scientists speculate that sex hormones may influence the severity and frequency of the symptoms and that they may also explain the lopsided distribution of the disease. Some researchers, however, speculate that that distribution may be less lopsided than it appears. They state that since men are less likely to go to the doctor for chronic pain than are women, fibromyalgia may be grossly underdiagnosed in men.
The science journal “Gynecology and Endocrinology” published a 2017 study in which researchers found that young women with premenstrual syndrome (PMS) were more likely to develop fibromyalgia than were young women who did not have PMS. They hypothesized that the cyclic decreases in the hormone estrogen caused greater sensitivity to pain. Similarly, women also see a drop in their hormone levels as they enter menopause. Some of these women develop fibromyalgia at that time.
Both men and women experience a drop in the hormone testosterone as they get older, and a decline in testosterone levels may also increase your susceptibility to fibromyalgia. While research in this area is so far scanty, the University of Nebraska Medical Center did conduct a study in 2010 in which the researchers found that older men were more likely to display suffer chronic pain like that of fibromyalgia as their testosterone levels declined.
The lower a man’s testosterone levels were, the more frequent and severe his pain tended to be.
Age
While many people believe that post-menopausal women are the ones most likely to develop fibromyalgia, the condition is actually most frequently diagnosed in women of reproductive age or between 20 and 50 years old. The stereotype about older women being the most commonly diagnosed patients probably stems from television commercials for fibromyalgia medications that cast such women as patients.
On the other hand, the risk of developing fibromyalgia does increase as you get older. An 80-year-old woman, for example, has an eight percent chance of developing fibromyalgia. By contrast, a younger woman has a two to four percent of developing fibromyalgia. Juvenile fibromyalgia syndrome (JFMS) is a comparatively rare form of the disorder that affects children and teenagers.
Genetics
Researchers believe that genetics can affect your chances of developing fibromyalgia. As there are hundreds of genes that may be involved in regulating pain, scientists haven’t yet determined which genes or combinations of genes might increase the risk of developing fibromyalgia.
Some researchers have hypothesized that the 5-HT2A receptor 102T/C polymorphism may increase the risk of developing fibromyalgia. A receptor is defined as a protein molecule that receives chemical signals from outside its cell, while polymorphism describes the condition of having two or more alleles or variants of a given gene in one place.
In 2010, the science journal “Rheumatology International” published an analysis of different studies of different gene polymorphisms that researchers had hypothesized might be linked to fibromyalgia. They concluded that some variants of 5-HT2A receptor 102T/C polymorphism did often occur in patients with fibromyalgia. The “Korean Journal of Internal Medicine” published a 2017 study conducted at the Chonnam National Medical Hospital.
The researchers there also found that certain genes are linked with fibromyalgia. They also found that those genes and incidences of fibromyalgia occurred in certain families. A susceptibility to fibromyalgia is thus partly hereditary.
Stress
Being under a lot of psychological stress can increase your chances of developing fibromyalgia. Of course, having fibromyalgia can add to your stress, which makes the connection analogous to that of the chicken and the egg. Doctors do know that fibromyalgia often develops alongside other stress-related disorders such as irritable bowel syndrome (IBS), post-traumatic stress disorder (PTSD), and chronic fatigue syndrome (CFS).
While they aren’t sure of the exact nature of the connections, researchers have observed that some psychological conditions like PTSD can trigger certain physical symptoms. Conversely, some physical conditions can trigger psychological reactions.
Consequently, some researchers believe that fibromyalgia can be divided into four subtypes:
- Fibromyalgia with no associated psychological conditions
- Fibromyalgia paired with clinical depression
- Fibromyalgia with pain-related depression
- Fibromyalgia caused by somatization or physical symptoms caused by a psychological disorder, such as PTSD
One of the more frustrating and disheartening aspects of fibromyalgia is the length of time it takes to secure a correct diagnosis. In too many cases, it can take years. The Academic Department of Rheumatology at King’s College London conducted a 2010 survey of fibromyalgia patients who had been experiencing symptoms for an average of 6.5 years.
Most of the patients waited nearly a year before visiting a doctor. It then took them an average of 2.3 years, during which they visited three or four doctors, to be diagnosed with fibromyalgia. The survey also found that over half of the patients considered their symptoms “very disruptive” or “extremely disruptive.” For example, 48 percent had missed at least 10 days of work over the last year due to their condition, and another 22 percent reported being unable to work at all.
