What is fibromyalgia?

La fibromyalgia is a syndrome characterized by diffuse pain all over the body, pain associated with great fatigue and sleep disturbances. This syndrome does not cause serious complications, but is very stressful and often prevents the sufferer from carrying out daily activities or performing a full-time job.

However, fibromyalgia is still poorly understood and poorly understood. Although the pain is real and very painful, doctors cannot detect any damage or inflammation that could explain these symptoms. For this reason, fibromyalgia has sparked some controversy in the scientific community, to the point that doctors did not believe in its existence. Today, it seems that certain physiological (abnormalities of the nervous system, hormonal disturbances, etc.) and genetic factors are involved. External events (trauma, infection, etc.) could also be involved. The exact causes, however, remain uncertain. The existence of this syndrome has been recognized since 1992 by the World Health Organization.

Find out more about the symptoms of fibromyalgia 

How do you recognize fibromyalgia? The diagnosis

His many symptoms and its resemblance or cohabitation with other diseases or syndromes (articular rheumatism, systemic diseases, chronic fatigue syndrome, irritable bowel syndrome, migraine, etc.) complicate the diagnostic fibromyalgia. Thus, it sometimes happens that sufferers must wait on average 5 years (and ten medical visits) before being diagnosed with fibromyalgia.³, even if this time has tended to decrease in recent years. Before making a diagnosis of fibromyalgia, doctors ask for additional examinations (in particular blood tests and x-rays) in order to rule out other diseases that would be treated otherwise.

Then, everywhere in the world, the diagnosis of fibromyalgia is based on two criteria established by theAmerican College of Rheumatology, selected and approved by an international committee:

• The presence of a diffuse pain for more than 3 months. The pain should be present on both sides of the body (left-right), at the top and bottom of the belt, as well as in the spine.
• A feeling of pain in at least 11 of the 18 characteristic points disease (see diagram opposite).

Notes. However, these criteria are criticized by many doctors, among other things because the number of 11 pain points is arbitrary. Thus, some people with 8 or 9 painful points can still have fibromyalgia.⁵⁹. In addition, the location and number of pain points can vary in the same person from day to day. Finally, some severe forms of fibromyalgia cause pain all over the body, not just the muscles.

What are the causes of fibromyalgia?

The causes of the syndrome are not yet known. Although the fibromyalgia generates chronic muscle pain, there is no visible lesion in the muscles that could explain the pain. It is a disease where many factors are probably the cause of the symptoms. Several hypotheses have been put forward. Here are the ones that are getting the most attention from researchers.

Exhaustion of the hypothalamic-pituitary-adrenal axis or stress axis:

We think that there could have been in predisposed people, a succession of 2 very important elements:

• In adolescence or childhood, a very emotionally trying event, a powerful stress for example an incest.
• In adulthood, on this predisposed ground, generally between 30 and 50 years old, on the occasion of a new stress, the person falls into the fibromyalgic syndrome.

This type of sequence is often found in people with fibromyalgia.

Decreased pain perception threshold

People with fibromyalgia feel pain more than others. In other words, their nervous system responds abnormally to external stimuli: a slight pressure is enough to trigger a “pain” message in people with fibromyalgia. This greater sensitivity to pain is linked to the dysfunction of certain areas of the brain and abnormalities in the transmission of nerve messages.

Physiological abnormalities of the nervous system

Several studies have shown decreased levels of neurotransmitters, such as glutamate or serotonin, in people with fibromyalgia. Likewise, hormonal abnormalities (involving the pituitary and thalamus, in the brain) have been described in fibromyalgia patients. None of these observations, however, can explain the disease on its own.

Genetic factors

It is now shown that fibromyalgia also has a genetic component, several people being affected in some families⁵⁹. Several genes could be involved in triggering fibromyalgia, but studies in this area have not yielded satisfactory results.

How many people are affected by fibromyalgia?

Statistics show that in industrialized countries, fibromyalgia affects 2% to 6% of the population. 

In France, the Ministry of Health estimates that around 2% of the population has fibromyalgia.

In Canada, 900 people are affected.

About 80% of those affected are women. The disease often appears around age 30 to 60. However, a few rare cases of fibromyalgia have been described in children, without being certain that it is the same disease.

See in detail who is affected by fibromyalgia 

Other avenues explored

Biological factors

A substance P metabolic disorder would increase sensitivity to pain. Its association with stress, anxiety and depression is also known.

A chronic lack of sleep repairman. It may be that poor sleep is not only a symptom, but also a cause of fibromyalgia.

Outdoor events

Many infectious agents have been incriminated to explain the onset of fibromyalgia, such as hepatitis C or B viruses, for example, or the bacteria involved in Lyme disease. About 10% of people with fibromyalgia report having had an infection before symptoms started⁶⁰.

In many cases, a physical trauma (accident) is involved in triggering fibromyalgia. Car accidents causing whiplash – trauma to the cervical vertebrae – are often blamed. From emotional trauma may also be involved, but not all cases of fibromyalgia⁶⁰. This is the case with sexual abuse or violence occurring early in life, as well as certain dramatic events (assault, attack, etc.).

How does fibromyalgia progress?

La fibromyalgia is not a serious illness, in the sense that it does not cause major health complications. It is nonetheless a painful and debilitating disease for the people who suffer from it. The pain is chronic and often resistant to various treatments, whether medical, physical or psychological. However, they tend to stay stable in the long term, or to subside. Usually there is no aggravation.

Visit our page on fibromyalgia treatment and prevention 

The intensity of pain and fatigue limits daily activities and can sometimes have an impact on the patient’s body.professional activity. However, maintaining one’s professional activity is beneficial both psychologically and physically, as a Swedish study showed in 2005.⁶². Work time and shift adjustments are sometimes necessary when the pain is very severe.