Aetiology

The exact aetilogy of fibromyalgia is unknown. The following factors are thought to be responsible:

• altered central pain processing - fibromyalgia patients develop a lower threshold of pain perception in the brain.
• dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis
• sleep disturbances -healing of muscle microtrauma may be impaired. Disturbed fourth phase of sleep results in a deficit of GH and insulin-like growth factor 1 (IGF-1) which are involved in muscle microtrauma repair
• genetic factors
• immune system - fibromyalgia is common in patients affected by autoimmune diseases
• psychiatric aspect - psychiatric conditions are more prevalent in fibromyalgia than among subjects complaining of other rheumatic diseases, depression is more frequently associated with fibromyalgia than with other musculoskeletal diseases (1)
• trigger factors - infections, physical trauma, chemical substances etc may act as trigger factors in fibromyalgia (1)

Reference:

• (1) Bellato E et al. Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment. Pain Res Treat. 2012;2012:426130.