Causes of fibromyalgia
Not yet defined with absolute certainty, the etiological factors of fibromyalgia are numerous and for this reason the disease is defined as multifactorial genesis .
There is clearly a triggering event that relates to the onset of the morbid state, which can be physical, mental, trauma, viral disease or even an allergic form.
According to the most recent guidelines, there are anomalies affecting neurotransmitters , which are the chemical mediators responsible for intercellular communication.
Even a hormonal hypothesis is taken into account since hormones are substances which, in turn, transmit biochemical messages between the various cellular compartments.
The causes of fibromyalgia can be grouped into various classes.
1. Neurotransmitter modifications
Some brain neurotransmitters, such as dopamine , serotonin , norepinephrine and gamma-amino butyric acid (GABA) are synthesized in significant quantities in response to strong endogenous or exogenous stress.
Their high concentration can contribute to the onset of the typical symptomatology , which in fact occurs simultaneously with perceptual changes at the level of the psycho-emotional sphere.
These nerve substances also control the endocrine and immune systems, helping to intensify neural stimulations on the musculoskeletal system.
On the other hand, the hyperactivity of theautonomic (orthosympathetic) nervous system responsible for the increased production of serotonin and norepinephrine, causes a decrease in muscle blood supply, which results in painful manifestations.
Stress is considered one of the most important predisposing factors for the onset of the pathology since the correlation between traumatic events and onset of symptoms has been confirmed.
Fibromyalgia is in fact often associated with post-traumatic disorder , chronic fatigue syndrome or even irritable colon , as many diseases resulting from stressful episodes.
Not only psychic but also organic traumas are called into question to explain the genesis of the disorder, which therefore can be linked to physical or emotional stress.
The hormonal component is closely involved in the onset of fibromyalgia, with particular reference to the hypothalamic-pituitary-adrenal axis .
The development of the pathology seems in fact to be connected to a lower response of the adrenal to stimulation by the adrenocorticotropic hormone (ACTH) , with a concomitant decrease in the quantitative values of cortisol .
Some recent neuroendocrine studies have focused on the relationship between the ACTH man and the onset of painful symptoms, especially at the tendon level, which is a constant etiological factor for fibromyalgia.
4. Genetic component
There is a family predisposition for this pathology, which probably derives from a polygenic transmission .
Although we cannot speak of a proper genetic transmission, numerous clinical researches have highlighted how genetic mutations can sensitize individuals to develop the disease, which is associated with genetic polymorphisms related to the neurotransmission system (dopaminergic, serotonergic and catecholaminergic).
These alterations, although not specific to fibromyalgia, are however related to functional modifications of the muscular and tendon system and confirm the connection betweenpsychic sphere and morbid framework already widely analyzed.
We can therefore speak of a genetic predisposition for people who, being more vulnerable to psychological stress and the perception of pain, are also more easily subject to the onset of fibromyalgia.
Some viral pathologies seem to be responsible for the appearance or aggravation of this morbid picture, in particular fibromyalgia arises following infectious mononucleosis , Lyme disease , or bacterial contamination syndrome localized at the level of the small intestine.