What other variables play a role in the etiology of fibromyalgia?

Updated: Apr 23, 2020
  • Author: Chad S Boomershine, MD, PhD, CPI, CPT; Chief Editor: Herbert S Diamond, MD  more...
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Age is an important variable. While most patients begin to experience symptoms between the ages of 20 and 50 years, the prevalence of the syndrome increases with age. The highest prevalence occurs between ages 60 and 79 years. [63]

Physical deconditioning is also an important variable. Moldofsky et al showed that disrupting stage 4 sleep in sedentary healthy controls elicited the appearance of musculoskeletal and mood symptoms similar to those seen in fibromyalgia patients. [55] However, when similar sleep disruption was performed in healthy controls who were regular exercisers, fibromyalgia symptoms did not develop. [64] This implies that regular physical activity may be protective and underscores the importance of maintaining physical activity in fibromyalgia patients.

While considered unlikely to be sole triggers, infection may also contribute to exacerbation of symptoms via cytokine–vagus nerve stimulation of the corticotropin-releasing hormone neuron/stress response system in bidirectional brain–immune system communication. [8]

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