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There is no clear cause attributable to the disease, but different theories have been used to explain its onset.
Some recent studies highlight that patients with fibromyalgia present changes in theirnociceptive system (a group of nervous system structures which regulate the perception and response to pain).
This means patients suffer a widespread reduction in their threshold to the perception of painful stimuli which affects different tissues such as muscles, skin, bones, tendons and ligaments, thus resulting in widespread, spontaneous pain predominantly in central structures (the back) as well as painful responses to non-painful stimuli, mainly upon moving different parts of the body.
Patients detect different stimuli (cold, heat, or pressure) as they normally would, but the stimuli produce pain at a much lower threshold. They also experience changes in the brain, with increased activity in the areas that process pain (both emotional and sensory areas), and reduced levels of neurotransmitters (chemicals that transmit information from one neuron to the next), which act as a barrier against painful sensations. Two of the neurotransmitters associated with fibromyalgia are noradrenaline and serotonin.
Another recent discovery is that 70% of C-type nerve fibres (responsible for conducting painful stimuli from the peripheral tissues to the spinal cord) are damaged [in patients with fibromyalgia]. This is a key factor when trying to explain the pain and other sensory symptoms as well as the induction mechanisms and maintenance of the disease.
Fibromyalgia is a syndrome that arises because of peripheral and central alterations to the nociceptive system, with repercussions on the autonomic nervous system, the neuroendocrine system and collateral effects on the activity of other motor and somatosensory areas of the cerebral cortex.
Risk factors associated with Fibromyalgia
The factors that predispose a greater likelihood of developing fibromyalgia are:
Chronic or recurrent pain in a region of the body.
Viral or bacterial infections.
The nociceptive system is a highly specialised group of nervous system components whose purpose is to detect possible threats or damage to the body, to its normal function or in its relationship with the surrounding environment. The nociceptive system is therefore responsible for detecting and analysing all potentially harmful stimuli.
The nociceptor system comprises receptors located in every tissue type throughout the body (skin, muscle, viscera, and so on). These receptors are usually at rest and become excited when they receive high-intensity and, therefore, potentially harmful stimuli. A wound or lesion does not necessarily have to be produced for them to be activated, just an intense stimulus. The level of stimulation at which the receptors become excited is called the pain threshold. Activation of these receptors causes a cell excitation process that travels to the spinal cord and triggers the release of neurotransmitters which then excite neighbouring cells, thus provoking and regulating the transmission of information about pain to the brain.
Once the pain is perceived, the nociceptive system activates the neurons that form part of the warning system, so the body can respond quickly and prevent the potential injury.