What Causes Fibromyalgia? The Latest News in Factors and Treatment

By: Michael Lam, MD, MPH

What causes Fibromyalgia?

There is no defined cause or mechanism behind what causes fibromyalgiaFibromyalgia is a condition characterized by widespread pain of the joints and muscles, as well as a variety of other symptoms including fatigue, sleep disturbances, cognitive impairment, depression, temperature sensitivity, headaches and muscle weakness. It is currently unknown what causes fibromyalgia, but some theories exist as to its etiology. The current criteria for diagnosis is widespread pain defined as affecting all four quadrants of the body and lasting for more than three months, fatigue, waking unrefreshed, and cognitive impairment, along with the absence of any other condition that could cause symptoms.

How is it treated?

There are no medications that have been developed to treat fibromyalgia, and no known cures. Current treatment protocols are designed to palliatively alleviate symptoms. Some common treatments include cognitive and exercise therapy, antidepressants to manage depression and anxiety, pain relievers to address the widespread pain, some anti-seizure drugs to help with pain, and stress reduction techniques and therapy to deal with stressful situations.

What are some factors that may cause Fibromyalgia?

Since what causes fibromyalgia is not definitively known, there is no single accepted pathology of the condition. There are, however, a variety of factors common amongst sufferers of the condition that strongly suggest some pathways. Some of these factors include:

  • Neuroendocrine imbalances in the brain hypothesized to cause abnormalities in pain processing and amplify painful sensations, thereby causing the widespread pain characteristic of fibromyalgia. Fibromyalgia tends to be more common in families, which suggests a genetic component; and in fact, several genes have been identified that occur more commonly in fibromyalgia patients than the general population
  • Infection or illness can trigger or aggravate fibromyalgia in some sufferers. It is not known if fibromyalgia can be caused by some ailments or if it simply augments the symptoms of the underlying dysfunction to a noticeable level.
  • What causes fibromyalgia is unknown, however the link with depression is clearDepression is another common factor amongst those with fibromyalgia. The exact nature of the relationship is not completely clear, but depressive disorders tend to increase the risk of developing chronic pain; and sufferers of depression ascribe more hindrance from pain. At the same time, pain from fibromyalgia can isolate individuals as they focus on the pain and suffering at the expense of the rest of their life, including their friends, family, and loved ones. This isolation and negative focus on the condition, risks development of depressive feelings. Whichever comes first, and it may be different for different people, fibromyalgia and depression form a feedback loop that aggravates both conditions.
  • Many fibromyalgia sufferers also have a history of traumatic or chronic stress that can lead to reduced memory function.
  • In fact, many other stress-related disorders such as chronic fatigue syndrome (CFS), posttraumatic stress disorder (PTSD), and Adrenal Fatigue Syndrome (AFS), are more common in those diagnosed with fibromyalgia than in the general population. Specific stresses such as smoking and obesity from poor lifestyle choices are suggested to be risk factors for what causes fibromyalgia. Chronic stress affecting function of the hypothalamic-pituitary-adrenal (HPA) axis has also been proposed as a trigger for the development of fibromyalgia.

The adrenal perspective

The adrenal glands are the body’s stress control center, and are employed any time the body’s homeostasis is threatened by outside stressors. If stress is chronic, the adrenal glands have to work constantly, and over time they can tire, and even begin to break down if overworked for long enough. This stress-mediated decline in adrenal function results in neuroendocrine imbalances that that cause a condition known as Adrenal Fatigue Syndrome (AFS). Some of the symptoms of AFS include fatigue, unexplained muscle and joint pain, increased susceptibility to infection, impaired cognitive function and depression.

There is a strong connection between the adrenals and what causes fibromyalgia, so properly recovering the adrenals can resolve many fibromyalgia symptomsYou may have noticed these symptoms are strikingly similar to some of the symptoms of fibromyalgia. When we consider the evidence that both conditions share many causal factors such as stress and neuroendocrine imbalances, it is not difficult to imagine the conditions may be deeply connected. Adrenal dysfunction leading to neuroendocrine imbalances and AFS, may for many sufferers, be the cause of, or at least a powerful contributing factor to, developing fibromyalgia.

Recovering from AFS through a combination of stress reduction, diet optimization, and nutritional supplementation therapies, actually spontaneously resolves many of the neuroendocrine symptoms of fibromyalgia in some sufferers. So if you have been diagnosed with fibromyalgia, there is a good chance there is also underlying AFS that may be aggravating or even causing many of the symptoms.

There is no defined cause or mechanism behind fibromyalgia

5 - "Hi,"

Thank you for great articles. They have been very helpful to me and I am definitely going to share this website with other people I know are suffering from the same condition as I am.


  • Andrea A says:

    Hello Dr Lam, I suffered from Fibromyalgia which was definitively diagnosed by several Drs & rheumatologists. Indeed, as you have said, conventional medicine has no known cure. I did, however, recover, and the treatment that cured me was in alternative medicine: bee venom therapy. I received the treatment via injections from a physician (now retired) who had 30 years of expertise in this area. The treatment was once a week for 20 weeks, and I have not been ill since. I sometimes get booster injections once a year. Unfortunately, apitherapy is not a recognized treatment modality in the US which is a shame because it can help so many conditions. But there is no question but that it did cure my Fibromylagia, which I might add was severe, so I wanted to share my experience with you. Thank you for your very informative newsletter & articles.

    • Dr.Lam says:

      I am glad to know it worked for you. CFS and AFS are similar but has great differences. Click Chronic Fatigue Syndrome & Adrenal Fatigue for more information.

      • Andrea A says:

        Thank you Dr Lam. I had 3 autoimmune illnesses – Fibromyalgia, Chronic Fatigue Syndrome, & Sjögren’s Syndrome, which were all eradicated by the bee venom therapy. Tests revealed that Adrenal Fatigue (among other things) was at the bottom of it. I get booster treatments whenever I’ve undergone (or am undergoing) a period of unusual stress, whether acute or ongoing, to make sure my body isn’t adversely affected. My doctors also prescribe many of the things you mention in your articles, which is why I find your newsletter so valuable. Thank you again for all the great information you share with your readers!

        • kathy zeitlin says:

          What country do you live in? I am so sick of the condition~would love to try anything!