Abuse is the Leading Cause of Fibromyalgia – Study

by Naomi Prex Arbaa, MD

Fibromyalgia  is a pain disorder, with symptoms ranging from muscle pain and numbness in the extremities to sleep disturbances. Inflammation and the body’s reaction to stress via the complex interactions between the brain and other organs play a role in fibromyalgia. It may be difficult to avoid the stresses that modern living throws at us, but there is certainly a lot that we have control over that can help to relieve the symptoms of this condition, including lifestyle habit and dietary choices.

Abuse is the leading cause of fibromyalgia

There is no simple or single answer to why emotional abuse or distress may trigger fibromyalgia. Emotional stress can weaken your ability to ward off various chronic pain diseases such as FMS. It is also believed that there is a link between emotional trauma, sleeplessness, headaches, pain and other symptoms.Victimization at an early age can have a severe long term impact.

It appears that emotional abuse has been taken less seriously than physical abuse because it does not have outward signs like bruises or broken bones. Yet, the higher instances of emotional abuse, particularly in childhood but also in adulthood, associated with individuals who have fibromyalgia indicate the need to be aware of the potential to develop fibromyalgia.

Childhood Trauma

Traumatic experiences and stress in childhood have historically been overlooked as predisposing factors in the development of various chronic pain disorders and psychiatric conditions, including fibromyalgia, irritable bowel syndrome, insomnia, depression, anxiety, post-traumatic stress disorder, and chronic fatigue syndrome. However, the tide is turning as research is revealing a significant correlation between childhood trauma and adult health.

The central nervous system is rapidly developing during childhood and being conditioned to respond to various stimuli and stress that are encountered in life. As an assortment of environmental stimuli are encountered, new pathways are created between the cells of the brain in response to each stimulus.

For example, a pleasurable experience such as a hug from a parent or a sweet food creates pathways that teach the brain to respond pleasurably to those stimuli. Likewise, a frightening experience will create and exercise pathways that respond in fear.

This process of creating new pathways in response to stimuli is referred to as neuroplasticity. As we age, neuroplasticity decreases, meaning it is more difficult to develop new pathways and adjust our brain’s responses to stimuli. Children are at a distinct advantage in possessing a high degree of neuroplasticity.

However, this also highlights the importance of delivering meaningful stimuli to the developing brain, to ensure the development of positive pathways.

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Traumatic experiences that are related with fibromyalgia include:

  • << Accident
  • << Emotional Trauma
  • << Certain viruses such as hepatitis C and HIV
  • << A childhood separation from your mother and it lasted more than 6 months.
  • << Living through a war.

Read More “Fibromyalgia is linked with Childhood stress and unprocessed negative emotions

More on Trauma :

There are several types of trauma or traumatic events that may contribute to the onset of fibromyalgia such as:  

Major injuries– mainly the types of injuries referred to are neck and/or upper back/body injury that may be sustained from a motor vehicle accident. In fact, people who have had motor vehicle accidents and sustained whiplash type injuries have been found to be 10-13% more likely to develop fibromyalgia following their injuries. This may occur anywhere from weeks to months following the trauma.

Infections– People who are predisposed genetically to fibromyalgia may develop symptoms of fibromyalgia following infections such as hepatitis, HIV infections, certain strains of the flu or other respiratory infections. People who have fibromyalgia tend to experience a flare up during infections as well.

Emotional Trauma-PTSD or even moderate stressors can trigger fibromyalgia symptoms. This can occur due to the drop of serotonin in the brain and substance P increasing in the brain. This chemical response or change has been seen in patients who have fibromyalgia. Again, people who are genetically predisposed to fibromyalgia are more likely to see a link of emotional trauma with the development of fibromyalgia.

  When physical trauma occurs to a person in the form of major injury or muscular type injuries, such as whiplash, this can affect nerves and the small muscles in your body. When these tiny muscles get injured severely enough or even get torn, they can cause the formation of what we know as trigger points in the soft tissues of the body.

These trigger points are what doctors evaluate in the diagnoses phase of fibromyalgia and due to the injuries of those muscles, the trigger points become very painful and sensitive when touched.  Researchers have found that people who develop fibromyalgia after physical injury or trauma are more likely to be the ones who have more physically debilitating type symptoms.

So how does childhood trauma or emotion trauma trigger fibromyalgia when there is no current “injury mechanism” that may instigate symptoms? Earlier I mentioned the change in serotonin and substance P levels in the brain that are the chemicals that signal pain and heightens pain response, and, that fibromyalgia is a change in the way the brain responds to pain? Well, childhood traumas, abuse, severe illness or other psychologically stressful events can be so emotionally painful and mentally unsettling that this can start to cause changes in the central nervous system which is the system involved in pain responses.

This can also trigger emotional pain responses that can manifest in physical pain experiences that do not have tissue injury pathology. So essentially when a person is told “it’s all in your head,” it’s not completely incorrect. However this shows that there is truly a physical cause due to emotional circumstances.

Other Types of Trauma

Other types of trauma or stressful type events that may also be linked to the onset of fibromyalgia symptoms that may not include neck/head injury or trauma may include; major surgery, childbirth, deployment to war, or any other highly stressful event that may occur in your life.

Genetic disposition and psychological stress can also cause onset of symptoms. So with this information it seems there should be some possibility of treatment to help alleviate pain and if your fibromyalgia was brought on by physical injury, it seems reasonable that treating the original injury should bring some relief. For some patients this is true and treatments ranging from chiropractic care to acupuncture, spinal traction, or any other treatment to help heal the original injury can result in a significant decrease in pain and symptoms.

It is best to make sure your doctor is aware of any injury or physical trauma that occurred prior to your fibromyalgia diagnosis so that you can work with them and look into treatments you can try to possibly help treat the original injury. If your fibromyalgia was triggered by a psychological or emotional trauma, along with any treatments you may be trying to help relieve the physical pain, seeing a mental health professional could prove to be very beneficial as well.

Trying to heal some of the emotional pain can help ease some of the physical pain as well since there is a strong link from mental health to physical health. And as we all know in dealing with this condition, there is no one “cure all” or magical pill or treatment that will get rid of fibromyalgia, but trying to treat multiple symptoms either medically or emotionally can hopefully lead to a less painful life.

 

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Sexual Abuse

Note: This is Abstract, if you want to read complete Study, It links are enlisted in References(At end of article)

According to studies, about 30-40 percent of adults have suffered physical, emotional, or sexual abuse at some point in their childhoods. Other studies suggest that the actual statistics may be much higher and under-reported. Several studies have looked at the role of sexual abuse and fibromyalgia specifically, and the results are shocking. In several studies, about 65 percent of women with fibromyalgia reported sexual abuse.

Although researchers do not quite know how or why childhood abuse is linked to fibromyalgia, it is important to consider abuse’s role in the steps taken to heal and control fibromyalgia symptoms. Much of the research about abuse and fibromyalgia has emerged within the past 5-10 years. This means that there is little hard evidence that pins down how abuse can influence fibromyalgia symptoms in the future.

A 1995 study conducted by McGill University in Canada found that in a group of 83 women with fibromyalgia and 161 women in the control group, 37 percent of women in the fibromyalgia group had experienced childhood sexual abuse.

Only 22 percent of women in the control group reported childhood sexual abuse. Women in the fibromyalgia group also reported higher levels of physical abuse (18 percent vs. 4 percent), drug abuse (16 percent vs. 3 percent), and lifetime sexual abuse (17 percent vs. 6 percent).

Of particular interest is a study performed in Birmingham, Alabama which suggested that people with fibromyalgia were statistically more likely to have had a history of past sexual or physical abuse, though other studies seemed to disprove these results.

The results of a study published by the American College of Rheumatology in its journal, Arthritis and Rheumatism showed that 65% of female fibromyalgia patients reported past sexual abuse as compared to 52% of the healthy control participants. This study found that the fibromyalgia patients with a history of abuse reported more symptoms than those fibromyalgia patients without this childhood history.

The researchers felt that the study proved only that a history of abuse brought on a greater severity in the symptoms of fibromyalgia though such abuse didn’t appear to be the cause of the syndrome itself.

Fibromyalgia patients with a history of such past abuse would do well to discuss this with their care providers. Therapy is always recommended as a remedy for abuse, and fibromyalgia patients are no exception to the rule. No one can say for sure, but it makes sense that dealing with the aftermath of such abuse just may help fibromyalgia patients obtain a better quality of life.

Recommended treatment

Recommended treatments include counseling, cognitive behavioral therapy, hypnotherapy, post-traumatic stresses disorder therapies and anti-depressant medications such as Cymbalta (duloxetine) and Effexor (venlafaxine).

Above all, when you are caring for someone who has pain without clear tissue pathology or who has recognized intensified emotional pain processing, reassure the person that the pain experience is not in his or her head, but rather in his or her nervous system.

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Related Article:

Trauma- How does it relate to fibromyalgia

Study References:

  • History of early abuse as a predictor of treatment response in patients with fibromyalgia: a post-hoc analysis of a 12-week, randomized, double-blind, placebo-controlled trial of paroxetine controlled release. via NCBI, PubMed
  • Sexual and physical abuse in women with fibromyalgia syndrome. via NCBI, PubMed.
  • The prevalence of sexual abuse in women with fibromyalgia via Wiley Online Library. Ref 

References:

  • Is Fibromyalgia Caused by Childhood Trauma? By Pat Anson, Editor via Pain News Network
  • The Sexual Abuse Question via Fibromyalgia Symptoms

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