–A Serious Multi-System Disease
What is fibromyalgia is illustrated by this cartoon indicating that it affects all the body’s controls and feels like a bad case of the flu.
Invisible, unpredictable, frustrating, and oftentimes torturous sums up fibromyalgia. The painful, diffuse symptoms have no boundaries and the disease robs you of restful sleep. You wake up each morning feeling like the fibromyalgia monster punched you around all night. Your muscles are stiff, your brain is dead, and you’re exhausted before the day begins.
Fibromyalgia affects every system in your body, but lab tests don’t explain your long list of symptoms. You look normal and feel awful; living with the disease is a constant struggle that others can’t see.
Feels Like the Flu
Most people with fibromyalgia say it feels like a bad case of the flu that never goes away. Scientifically, evidence supports the concept that the disease resembles a chronic viral infection.
When viruses invade your body, the immune cells in your central nervous system go ballistic to protect your brain. In doing so, your neurons send pain alarms out to your muscles and other tissues. The nervous system dysfunction causes fatigue, trouble concentrating (brain fog), insomnia, and a deflated mood. It’s the very thing that lands people in bed when an infectious agent invades their body.
Research shows that the immune cells in the brain are on the rampage in people with fibromyalgia. But instead of causing symptoms for only a day or two, these cells remain in the “enraged” mode. This produces a chronic state of flu-like symptoms.
Brain imaging studies funded by AFSA document the hyperactivity of these immune cells in fibromyalgia patients.1 However, standard blood tests fail to detect this activity because these cells hide out in the central nervous system. On the other hand, ongoing research funded by AFSA attempts to show that the neutrophils and cytokines in the blood may be useful disease severity markers.
Alters Body Functions
Doctors often tell fibromyalgia patients that there is nothing wrong with them because tests do not reveal a tissue-destroying process. This is insulting given the multitude of symptoms. Yet, the absence of tissue destruction should be viewed with optimism. It may mean that researchers can reverse the processes causing this condition.
Instead of being a destructive disease, fibromyalgia alters the way your brain and spinal cord operate. In turn, this dysfunction spills over into problems with regulating all your organ systems, such as your digestive tract, your natural stress response mechanisms, and your cardiovascular system, to name a few. It’s as though the messages entering your central nervous system become scrambled, leading to aberrant signals to all body systems.
Illustration diagram showing how genetics combined with a triggering event alters your brain and body systems to cause fibromyalgia.
Fibromyalgia is like having a foreign invader inside your body who changes all your control settings so nothing works correctly. Your mind can’t focus, your digestion is fussy, the blood flow to your muscles is impaired, the slightest touch hurts, bright lights and other sensory signals are overwhelming, your coordination is off, and your head constantly pounds. The long list of symptoms makes you feel twenty years older … and then some.2
What Causes Fibromyalgia?
What sets the fibromyalgia wheels in motion? Genetics plays a big role. Blood relatives of patients are eight times more likely to develop the condition.3 Genetic predisposition coupled with exposure to a triggering event causes the symptoms to surface. The most common triggers are infections, injuries, development of another disease, prolonged stress, or trauma. These events activate the immune cells in the nervous system (called microglia) and impair the body’s ability to fight pain. However, it’s still unclear how this leads to fibro.
Views on what causes fibromyalgia constantly change. Initially, researchers thought muscle inflammation caused it, but studies quickly dispelled this myth. Next, it was viewed as a disease of the central nervous system. While partly true, injecting mice with serum or gut bacteria from fibromyalgia patients causes a rapid onset of pain.4,5 This shows that cells outside the nervous system also contribute to the disease.
Today, fibromyalgia is more than a central nervous system disease. Your digestive, metabolic, hormonal, and immune systems collude with the control centers in your brain to cause the disease. And despite its impact on all your body systems, fibromyalgia lurks in the shadows, undetectable by standard laboratory tests.
Illustration diagram of what fibromyalgia is: a serious multi-system disease.
Although fibromyalgia is not an inflammatory disease like rheumatoid arthritis, a more subtle form of inflammation exists. Research shows a wide variety of immune cells behave abnormally.6,7 Each of these cells can produce symptoms, but scientists are still figuring out the mechanisms that link immune cells to other processes occurring in this disease. In fact, understanding the immune system’s role in causing symptom flares is the focus of an AFSA 2024 award.