“The triggers of Fibromyalgia”

This Informative Summary of Fibromyalgia is a way to disseminate Fibromyalgia, based on the research and practice of Dr. Manuel Martínez Lavín, Mexican, one of the greatest experts in Fibromyalgia.

The general theme is the etiopathogenesis or cause-origin of fibromyalgia, that is, the mechanisms or various factors that lead to fibromyalgia, both genetic and environmental predisposing and affecting the development of the disease.

ccording to Dr. Manuel Martínez Lavín, fibromyalgia falls as a neuropathic pain syndrome maintained by sympathetic hyperactivity. Since fibromyalgia is a condition related to ESR, it also discusses what could be the nerve center in its pathogenesis: the way in which distress can be transformed into chronic pain.

Genetic predisposition

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For Dr. Manuel Martínez Lavín, there is a genetic predisposition to develop fibromyalgia. The direct relatives of those affected are eight times more likely to develop the condition than the general population. Studies in twin individuals suggest that approximately 50% of the factors that lead to fibromyalgia are heritable and the other half environmental.

Several groups of researchers have focused on studying variations in genes related to the stress response system. Most studies have been positive. Patients with fibromyalgia have different polymorphisms of the catechol-o-methyl transferase gene and serotonin and are associated with an enzyme deficient in its ability to degrade catecholamines (adrenaline) and dysfunctional adrenergic receptors.

Environmental factors

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The study of the cohort of individuals born in the British Isles in 1958 has allowed the prospective definition of various events in the course of people’s lives, which could be risk factors for the subsequent development of chronic widespread pain. These situations were: adverse events during childhood such as family conflicts, the death of the father or the mother, economic limitations or inadequate socialization in the school years. It also suggests that an insane lifestyle is another risk factor for the development of this type of symptoms. Fatty food intake, obesity, physical inactivity and smoking increase the risk of developing chronic pain. 

Physical injuries, particularly car accidents where a “whiplash” of the cervical spine occurs, are another triggering event of fibromyalgia. Also the various emotional traumas, including sexual abuse, workplace harassment, divorce or the death of a loved one. Fighters of various wars develop syndromes similar to fibromyalgia. 

Various infectious agents can promote the development of fibromyalgia, 

Stress and distress

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According to Dr. Martínez Lavín, it is evident that the development of fibromyalgia is associated with stressors, whether physical, infectious or emotional. For him, stress is “any stimulus, whether physical or emotional, that attempts against homeostasis”. Distress, coined by Selye, is the maladaptive response to stress that produces physical and / or emotional damage. m 
Distress is frequent in fibromyalgia. Anxiety and depression are two common manifestations. Often people suffering from fibromyalgia have a rigid and perfectionist personality. Obsessive in the performance of their tasks inside and outside the home, they exercise self-sacrifice to care for their loved ones.

 Dr. Martínez Lavín mentions the cerebrospinal fluid alterations, especially Vaeroy described elevated levels of substance P (primary pain neurotransmitter) in fibromyalgia patients. In relation to functional imaging, the Mountz group with fibromyalgia patients found decreased blood flow in the thalamus and in the caudate nucleus. The thalamus is a center for pain processing and autonomic function. Gracely’s group pressed the thumb of the fibromyalgia patients until they caused intense pain, the average pressure of 2.4.kg / cm2 was enough compared to 4.2kg / cm2 of the healthy ones. When performing fMRI during the sensation of intense pain, areas of the brain that register pain went on in both patients and controls,

Sleep disorder

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Moldofsky et al’s electroencephalographic studies showed that fibromyalgia patients had an intrusion of alpha waves in the deep states of sleep, and even developed diffuse pain and allodynia. More recent studies have shown that people with fibromyalgia have an increase in episodes of arousals and awakenings.

Phenomenon of resonance (“wind-up”)

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The group of Dr. Staud has shown that in people with fibromyalgia there is a phenomenon of resonance to painful stimuli, which reveals a sensitization of the somatosensory system.

In conclusion

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For Dr. Martínez Lavín, fibromyalgia is a neuropathic pain syndrome maintained by sympathetic hyperactivity based on the following three arguments: 
– The presence of chronic pain in the absence of damage to the body structure. 
– The presence of allodynia as a fundamental manifestation of fibromyalgia. 
– The presence of paresthesias as symptoms that distinguish the condition.

He proposes that fibromyalgia is a syndrome maintained by sympathetic hyperactivity based on the following three arguments: 
– Its frequent post-traumatic onset. 
– Data of incessant sympathetic dominance. 
– The doubly blinded study that showed that people with fibromyalgia have pain induced by injection of norepinephrine (adrenaline).

Another contribution of Dr. Martínez Lavín to the knowledge of the etiopathogenesis of fibromyalgia is how distress can be transformed into chronic pain. The dysautonomia of fibromyalgia, condenses the important pathogenic findings described by other groups of researchers in a comprehensive explanation. Dysautonomia is a clear explanation for sleep disorders and chronic fatigue.


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