Over the last fifteen years, scientists have gained more insight into the science behind fibromyalgia. Current evidence points to a sensitized or overactive central nervous system. Within the central nervous system is the brain, spinal cord, and over 400 nerves, all connected like a highway system.
What’s going on in my body?
Maybe you've been told that your pain is "all in your head." This is not true. Your pain is real and your symptoms are real too. It’s also true that pain is processed within the central nervous system, which includes the brain.
The pain is in your brain, not your mind.
Fibromyalgia is characterized by abnormal pain processing within the central nervous system. This is also called “central sensitization” as the nervous system has become more sensitive and overactive. In layman's terms, central sensitization is when the nervous system is on high alert even when there is no danger present.
Because the system is on high alert, it doesn't take much for your pain alarm to go off (ex: getting a poor night of sleep, a stressful conversation, overexertion, etc.). If your house were on fire, you'd want your smoke detectors to go off. However, you don't want your smoke detector going off if you're just toasting a piece of bread. Is your alarm system going off more than it should?
Why is my nervous system so sensitive? What caused my fibromyalgia?
Three mechanisms explain how a nervous system becomes more sensitive:
Previous damage or inflammation of peripheral tissue. Let's say you broke your ankle and had surgery a few years ago. Originally the pain was in your ankle and surrounding areas. However, over time your entire system became more sensitive. Remember, your nerves are connected like a highway system, so the pain can spread and shift from the original injury.
Genetics. The risk of developing fibromyalgia is about eight times higher for first-degree relatives of those with fibro, such as siblings or children, compared to the general population. More specifically, research has found the following gene pathways are involved in the development of fibromyalgia: serotonergic, dopaminergic, and catecholaminergic.
Psychological and behavioral factors, such as anxiety, fear of movement, and a focus on the pain. These factors best explain the ongoing sensitivity of the nervous system.
Check It Out
We've created a free e-book with science-backed information for all fibromyalgia warriors. Instead of spending hours and hours searching Google for answers on how the diagnosis process works, best treatment options, and causes of your pain, it's all right here!
Sources
Ablin, J. N., & Buskila, D. (2015). Update on the genetics of the fibromyalgia syndrome. Best practice & research. Clinical rheumatology, 29(1), 20–28. https://doi.org/10.1016/j.berh.2015.04.018
Boomershine C. S. (2015). Fibromyalgia: the prototypical central sensitivity syndrome. Current rheumatology reviews, 11(2), 131–145. https://doi.org/10.2174/1573397111666150619095007
Chinn, S., Caldwell, W., & Gritsenko, K. (2016). Fibromyalgia pathogenesis and treatment Options Update. Current pain and headache reports, 20(4), 25. https://doi.org/10.1007/s11916-016-0556-x
Clauw, D. (2015). Fibromyalgia and related conditions. Mayo Clinic Proceedings, 90(5), 680–692. https://doi.org/10.1016/j.mayocp.2015.03.014
Goldenberg, L. (2008). Understanding fibromyalgia and its related disorders. Primary care companion to the Journal of clinical psychiatry, 10(2), 133–144. https://doi.org/10.4088/pcc.v10n0208
Imrie, R. (2017). Fibromyalgia. InnovAiT, 10(1), 45–50. https://doi.org/10.1177/1755738016638865
Jay, G., & Barkin, R. (2015). Fibromyalgia. Disease-a-Month, 61(3), 66–111. https://doi.org/10.1016/j.disamonth.2015.01.002
Lichtenstein, A., Tiosano, S., & Amital, H. (2018). The complexities of fibromyalgia and its comorbidities. Current opinion in rheumatology, 30(1), 94–100. https://doi.org/10.1097/BOR.0000000000000464
Park, D. J., & Lee, S. S. (2017). New insights into the genetics of fibromyalgia. The Korean journal of internal medicine, 32(6), 984–995. https://doi.org/10.3904/kjim.2016.207
van Ittersum, M. W., van Wilgen, C. P., van der Schans, C. P., Lambrecht, L., Groothoff, J. W., & Nijs, J. (2014). Written pain neuroscience education in fibromyalgia: a multicenter randomized controlled trial. Pain practice: the official journal of World Institute of Pain,14(8), 689–700. https://doi.org/10.1111/papr.12137
Watson, J. A., Ryan, C. G., Cooper, L., Ellington, D., Whittle, R., Lavender, M., Dixon, J., Atkinson, G., Cooper, K., & Martin, D. J. (2019). Pain neuroscience education for adults with chronic musculoskeletal pain: a mixed-methods systematic review and meta-analysis.The journal of pain: official journal of the American Pain Society,20(10), 1140.e1–1140.e22. https://doi.org/10.1016/j.jpain.2019.02.011
Disclaimer
Fibromyalgia is not a "one size fits all" diagnosis. What works for some doesn't work for others. The information provided is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. Should you have any health-related questions, please consult your physician or other health care provider promptly.
Teresa & Hannah are fellow fibromyalgia warriors. Teresa is a certified dietary manager and wellness coach. Hannah is an occupational therapist. Together, we're a mother-daughter duo on a mission to empower others to fight against fibro.