by Jenny Ashmore


Fibromyalgia, is a systemic disease that causes pain in the muscles, joints, and connective tissues alongside a multitude of neurological and psychological manifestations [1]. Recently, certain organizations have re-coined it as myalgic encephalopathy, but they are both the same condition [2]. Fibromyalgia can affect adults and children; males and females; and people of all ethnicities and race– it does not discriminate. Even though we know it is very common, the literature on its prevalence is rather limited. A 2017 meta-analysis that reviewed 210 relevant scholarly articles, found that fibromyalgia was present in 0.2-6.6% of the general population, and 2.4% – 6.8% of women [3].  It is becoming increasingly clear that fibromyalgia is a very wide-spread disease that deserves more attention and research.

By far, the most prevalent symptom of fibromyalgia is widespread chronic pain. It can be felt above and below the waist, on both sides of the body, and last for at least 3 months. However, it may vary in its intensity and pain “quality” [4].  Additionally, it may affect bones, joints and muscles. Environmental and psychological stressors have been found to be possible triggers. Fibromyalgia can also cause sleep issues, brain fog and memory problems, persistent fatigue, depression, anxiety, etc. A survey conducted by the National Fibromyalgia Association [4] found that the top 5 reported symptoms of fibromyalgia are the following: lower back pain, frequent headaches, arthritis, muscle spasms, and tingling on the body. Symptoms such as: IBS (irritable bowel syndrome), chronic fatigue, bloating, balance issues, sinus problems, restless legs, dental complications, jaw pain, ear ringing (tinnitus), bladder issues, and rashes are most certainly worthy of honorable mention; as they are experienced by 25% (or more) of the people who have taken the survey.

Fibro Center, an organization that advocates for fibromyalgia awareness and helps patients obtain a diagnosis, published a brief summary of the possible causes of fibromyalgia [5]. The research includes the possibilities of genetic inheritance and triggers like accidents, injuries, traumatic events, and intense emotional stress. It’s also suspected to be caused by infections such as hepatitis c, Epstein-Barr virus, and Lyme disease. Of course, by default, this can also lead to the possibility that it is the result of an autoimmune process within a patient. Many autoimmune patients are well aware that having one autoimmune disease like; celiac disease, hidradenitis suppurativa, Crohn’s disease and rheumatoid arthritis significantly increases the chances of having another like fibromyalgia.

But, what is the exact mechanism behind fibromyalgia? It’s not 100% proven- but there is a theory that makes a lot of sense. The theory, according to several researchers, is that the shunts in between the arterioles in the body (tiny blood vessels) have too many nerves, which means that they are very sensitive to everyday sensations. This is an excerpt of what they theorize causes the pain and temperature issues that many patients with fibromyalgia experience:

“The excessive sensory innervation to the glabrous skin AVS [arteriole-venule shunts] is a likely source of severe pain and tenderness in the hands of fibromyalgia patients. Importantly, glabrous AVS regulate blood flow to the skin in humans for thermoregulation and to other tissues such as skeletal muscle during periods of increased metabolic demand. Therefore, blood flow dysregulation as a result of excessive innervation to AVS would likely contribute to the widespread deep pain and fatigue of fibromyalgia. SNRI compounds may provide partial therapeutic benefit by enhancing the impact of sympathetically mediated inhibitory modulation of the excess sensory innervation” [6].

There is no known cure for fibromyalgia, especially since the real cause is such a mystery. Most patients are treated with non-narcotic nerve pain medications such as pregabalin. Many are also treated with antidepressants because they affect neurotransmitter activity which could potentially be involved. Other treatments center around lifestyle modification, and include sleep hygiene, exercise, an anti-inflammatory diet, and cognitive-behavioral therapy [7].



  1. National Fibromyalgia Association (NFA). (n.d.). About Fibromyalgia. Retrieved October 18, 2017, from
  2. ME Association. (n.d.). What is ME/CFS? Retrieved October 18, 2017, from
  3. Rev Bras Reumatol Engl Ed. 2017 Jul-Aug;57(4):356-363. doi: 10.1016/j.rbre.2017.01.005. Epub 2017 Feb 8.
  4. Pfizer Inc. (2015, October 28). Common Fibromyalgia Symptoms. Retrieved October 18, 2017, from
  5. Possible Causes of Fibromyalgia. (2014, December 16). Retrieved March 16, 2018, from
  6. Albrecht, P. J., Hou, Q., Argoff, C. E., Storey, J. R., Wymer, J. P., & Rice, F. L. (2013, June). Excessive peptidergic sensory innervation of cutaneous arteriole-venule shunts (AVS) in the palmar glabrous skin of fibromyalgia patients: Implications for widespread deep tissue pain and fatigue. Retrieved March 16, 2018, from
  7. C. (n.d.). Treatment. Retrieved March 16, 2018, from