What causes fibromyalgia?

Diana Meeks
Diana Meeks on behalf of Sigma Nursing
Family Practitioner

For the most part, the cause of fibromyalgia is a mystery, but research has been able to shed a little light on the subject. It is very common for people to develop fibromyalgia following some type of physical or emotional trauma and stress seems to play a big role in that. However, exactly how stress affects fibromyalgia remains unclear. The condition has also been linked to certain infections and tends to run in families, leading researchers to believe that genetics are involved. This theory is further supported by the evidence of certain genes occurring more frequently in those suffering from fibromyalgia.

Debra Fulghum Bruce PhD
Healthcare Specialist

While there are many theories on what causes fibromyalgia, the truth remains that scientists do not know. For many years it was thought that the disease was caused by a disorder of the muscles or was a psychological problem.  Some researchers believe that this mystery syndrome may have a genetic disposition as it can run in families. The most recent research suggests that the muscles themselves are more likely not the source of the pain, but that the pain may be a response to changes in the brain. All of these explanations remain uncertain, but research is continuing.

No single theory seems to explain all of the problems in fibromyalgia. Whatever the cause, the vicious cycle of pain and disturbed sleep leads to less activity and depression, then to more pain. This pain cycle creates a situation that can become disabling and incapacitating for months and possibly years unless the proper treatment is administered to control the symptoms. While there is no cure, the symptoms can be successfully treated.


Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

No one knows exactly what causes fibromyalgia. You feel like you’ve gone 12 rounds with Mike Tyson, but your doctor’s telling you your tests look just dandy. But we do have some clues. Genes play a role. Some people with fibro have been shown to have certain genes that make them respond more acutely to stimuli that other people may not perceive as painful. But heredity doesn’t deserve all the blame. It can take more than genes to trigger fibromyalgia. An accident such as a car crash can awaken it. Emotional trauma, including post-traumatic stress disorder (PTSD), can also bring it on. So can a physical illness. Sometimes, though, fibromyalgia just develops without any immediate cause you can point to.

While the underlying cause or causes of fibromyalgia (FM) still remain a mystery, research findings continue to bring scientists closer to understanding the basic mechanisms of fibromyalgia. Most researchers agree that FM is a disorder of central processing with neuroendocrine and neurotransmitter dysregulation. The person with FM experiences pain amplification due to abnormal sensory processing in the central nervous system. An increasing number of scientific studies show multiple physiological abnormalities in the person with FM, including: increased levels of substance P in the spinal cord, low levels of blood flow to the thalamus region of the brain, hypothalamic-pituitary-adrenal (HPA) axis hypofunction, low levels of serotonin and tryptophan and abnormalities in cytokine function.

Studies show that genetic factors may predispose individuals to a genetic susceptibility to FM. For some, the onset of FM is slow; however, in a large percentage of people the onset is triggered by an illness or injury that causes trauma to the body. These events may act to incite an undetected physiological problem already present.

Exciting research has also begun in the areas of brain imaging and neurosurgery. Ongoing research will test the hypothesis that FM is caused by an interpretative defect in the central nervous system that brings about abnormal pain perception. Scientific researchers have just begun to untangle the truths about this life-altering disease.

The causes of FM are not known. Researchers think a number of factors might be involved. FM has been linked to:

  • Having a family history of fibromyalgia (i.e. genetics)
  • Being exposed to stressful or traumatic events, such as car accidents
  • Injuries to the body caused by performing the same action over and over again
  • Infections or illnesses
  • Being deployed to war

This answer is based on source information from the National Women's Health Information.

Dr. Jacob Teitelbaum
Integrative Medicine Specialist

Chronic fatigue syndrome and its painful cousin fibromyalgia represent an energy crisis where the body is spending more energy than it is able to make. When this occurs, the person "blows a fuse" called the hypothalamus—a major control center in the brain which regulates sleep, hormonal function, temperature, and other critical functions. Decreased energy in the muscles also results in chronic muscle shortening and pain (think writer’s cramp or even rigor mortis).

Dr. Randolph P. Martin, MD
Cardiologist (Heart Specialist)

Fibromyalgia currently has no single cause, but experts know that there is something going on in the central nervous system that causes an individual to be super sensitive to pain. Watch this video to learn more from Dr. Randy P. Martin about the causes of fibromyalgia.

Although the cause is unknown, some researchers think fibromyalgia may be the result of a genetic tendency, therefore, it may be passed on from generation to generation. When a person who has this tendency is exposed to certain emotional or physical stressors (like in an illness), there is a change in their body’s response to stress. This can result in a higher sensitivity of the entire body to pain. Scientists theorize that one of these body changes is a low level of a hormone, CRH (corticotropin-releasing hormone), resulting in higher sensitivity to pain and more fatigue, including the fatigue experienced after exercise.

This hypersensitivity to pain may in part be from low levels of serotonin. Serotonin is a neurotransmitter in the brain associated with a calming, anxiety reducing reaction. Lower levels of serotonin cause a lower pain threshold. The end result may be the chronic widespread pain of fibromyalgia.

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Dr. William B. Salt, MD

Fibromyalgia is one of many functional symptom syndromes, composed of medically unexplained symptoms, which are “caused” by dysfunction involving the mind/brain—body connection.

To explain the unexplainable and cause, look at the terms used here and then “see the big picture.”

  • Functional refers to how the body works.
  • Symptoms of fibromyalgia include chronic widespread pain, fatigue, and sleep disturbances.
  • Symptom Syndromes are collections of medically unexplained symptoms. They are also known as functional somatic syndromes and chronic multisymptom illnesses. Nearly every specialty defines at least one syndrome. Examples include RHEUMATOLOGY (fibromyalgia), UROLOGY (interstitial cystitis/painful bladder and chronic prostatitis/painful prostate), and GASTROENTEROLOGY (irritable bowel syndrome).
  • Medically Unexplained Symptoms (MUS) cannot be explained by medical tests, such as x-rays, endoscopies, and blood tests, because they are caused by dysfunction.
  • Dysfunction is disturbance or “malfunction” of how the body works.
  • Mind/Brain-Body Connection refers to how the mind/brain and body communicate and talk with one another.

MUS and symptom syndromes frequently overlap with one another and are commonly associated with and often attributed to stress, depression, anxiety, and/or panic. Medical and scientific research is showing how the mind/brain and body communicate and both how and why symptoms are generated. One of the most important discoveries is that the "central" mind/brain can become "sensitized" to "peripheral" body pain and symptom signals. So these symptom syndromes are now being called, central sensitivity syndromes.

A new book, Still Hurting? FIND HEALTH!, written by this author with Thomas L Hudson, MDiv JD, (, proposes a new unifying and holistic medical model of medically unexplained symptoms and their related symptom syndromes as chronic disease, explains both how and why they occur, and shows what people can do to help themselves and work effectively with their caregivers.

DISEASE IS DYSFUNCTION, AND SYMPTOMS ARE THE EXPRESSION. The cause of medically unexplained symptoms and pain can be understood as disease/dysfunction, regardless of whether the symptoms are widespread (e.g., the pain and fatigue of fibromyalgia) or localized to a specific area of the body (e.g., the abdominal pain and bowel dysfunction of irritable bowel syndrome). 

Dr. Dawn Marcus

In most cases, people don't know why their fibromyalgia started. The symptoms of fibromyalgia begin for approximately two in five people after an injury or trauma. A report published in the journal Rheumatology linked trauma from surgery and work injuries with fibromyalgia. Interestingly, fibromyalgia beginning after an injury tends to cause greater pain, disability, and emotional distress than fibromyalgia that begins with no obvious causal link.

Fibromyalgia may have been passed to you through your family. Recent studies suggest a strong family link with fibromyalgia.

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Dr. Michael Breus, PhD
Psychology Specialist

Fibromyalgia has a history that’s both contentious and mysterious. For a long time, there was no consensus in the medical community about whether it even existed, whether it was a “real” disorder or an “imagined” one. This has changed, and the medical establishment now overwhelmingly accepts that fibromyalgia exists as a very real disorder. But much about the syndrome—including and especially what causes it—remains unknown. For this reason, and because there is no single test that can positively identify fibromyalgia, it remains difficult to diagnose. Since it can’t be tested for, a diagnosis of fibromyalgia comes by way of eliminating other possible conditions.

There are signs of possible genetic and environmental links, since fibromyalgia seems to sometimes run in families. Researchers have explored links between fibromyalgia and other diseases and disorders, including arthritis, depression, anxiety, chronic fatigue and restless leg syndrome, but have found no conclusive evidence to demonstrate a causal link between fibromyalgia and these conditions. That said, all of these disorders are found more often in people with fibromyalgia than in the general population.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.