Most of the research findings in fibromyalgia point to an abnormal function of the central nervous system (CNS), which includes the brain and spinal cord. There also appear to be a variety of abnormalities occurring in the peripheral soft tissues (muscles and connective tissue) and the peripheral nervous system that communicates with the CNS. This dysfunctional relationship between the CNS and peripheral systems is believed by most investigators to be the source of the many body-wide symptoms. Fibromyalgia could be considered a disease of the CNS, but this would be too narrow of a view in understanding the complex web of neuro-endocrine and physiologic processes participating in this condition.
Central nervous system research on fibromyalgia:
- Alterations in pain-related chemical transmitters have been reported in the spinal fluid (particularly substance P, nerve growth factor, serotonin, norepinephrine, and corticotropin releasing factor).
- Elevated levels of pro-inflammatory cytokines, which are substances that form a communication link between your body’s immune and neurological systems, have been found by many research teams.
- Different brain imaging techniques by several research centers have all shown that the blood flow and metabolic processes in the brain are significantly disturbed.
- Almost all people with fibromyalgia report difficulties staying asleep (e.g., the natural processes in the brain that maintain sleep appear to be disrupted).
- The autonomic nervous system, whose control center (mesencephalon and intermediolateral cell column) resides at the base of the brain to communicate with the CNS to regulate the peripheral tissues, is not functioning properly.
- Research on the primary pain control system in the spinal cord indicates that it is not filtering out or dampening incoming noxious signals from the peripheral tissues.
- Several research studies pertaining to memory function tests show that people with fibromyalgia have an impaired ability to concentrate. (“Fibro Fog” related to the hippocampal area of the brain).
Research findings show that the peripheral tissues are also involved in producing the symptoms of fibromyalgia:
- Muscles are often tight and knotted with myofascial trigger points (areas in the belly of muscles that refer pain to other regions and cause restrictions in range of motion).
- High levels of a nitric oxide-producing enzyme was documented by one research team to help explain why patients have exercise intolerance.
- Excessive levels of oxidative chemicals that irritate the tissues were found in the connective tissues in the tiny space between the muscle fibers.
- Reduced blood flow to the muscles as well as a reduction in the number of capillaries supplying nutrients to the tissues were confirmed by different research teams … these findings are hypothesized to be caused by the malfunctioning in the autonomic nervous system.
The cause of fibromyalgia is not the same for everyone.
Various triggering events are thought to precipitate its onset. A few examples would be an infection (viral or bacterial), an automobile accident, an injury, surgery, or the development of another disorder, such as rheumatoid arthritis, lupus, or hypothyroidism. These triggering events probably do not cause fibromyalgia, but rather, they may result in the setting off of underlying physiological abnormalities that are already present.