Where does fibromyalgia pain come from?

Fibromyalgia (FM) creates many symptoms like chronic fatigue, muscle aches and pains, depression, sleep disturbance, and more. The severity of FM varies from mild to severe, leaving some totally disabled. Blood tests and imaging studies are negative, so where does the pain come from?

Since the usual markers of injury are negative, we know the pain is not coming from damaged tissue. The origin of pain appears to be the central nervous system. Parts of the brain and spinal cord receive pain signals and when they reach a certain threshold, sensation is felt. When the sensory input is below that level, it will not be felt. This thermostat-like function is vital so we do not feel everything, like the clothes hanging from our backs.

In the FM patient, this thermostat function is not working properly. It is set lower than normal, and as a result, patients feel more than they should. Basically, there is a nervous system overload.

How does this hypersensitivity start? Fibromyalgia is classified into two categories. In type I, primary FM, the cause is unknown. In type II, secondary FM, some other condition can be identified. These can include irritable bowel syndrome, rheumatoid arthritis, or previous trauma or illness. Lack of sleep may also cause FM. It takes about four hours of sustained sleep to reach deep sleep. Frequent sleep interruptions means the person never reaps the healing benefits of deep sleep. Over time, the body tightens up, too much sensory information reaches the brain, and a heightened pain level is perceived. Studies have shown that when sleep is restored, many patients gradually improve and function better.

FM is usually multi-factorial and including alternative approaches leads to better results. Chiropractic, acupuncture and nutritional therapy can facilitate sleep restoration, improve nervous system function, and decrease pain in FM patients.

For more information, email Dr. Wendy at [email protected].