A Journey from Frustration to Self Management

Causes of  Fatigue (Fibromyalgia)

Most of you have been searching for the causes of fibromyalgia that result in pain and fatigue.  Most fibromyalgia patients complain of disturbed sleep, distress, pronounced fatigue and pain.   Fibromyalgia is just another one of the chronic syndromes that has NO singular cause.

The cause of Fatigue is most likely impulse input from deep tissue particularly muscles.  Constant impulse stimulation results in Central Nerve (CNS) Sensitization.  This process probably begins with Peripheral Nerve (PNS) Sensitization due to a number of factors including trauma.  

In laymen terms it is like rubbing one spot on your skin.  After several minutes that area becomes sore, then painful and then almost intolerable. Fibro works havoc at a much deeper level.

Unfortunately, cause of fibromyalgia may be increased sensitivity to stressful events. These abnormalities can and do trigger symptoms that are found in fibro patients, including pain, fatigue, insomnia, weakness and mood disorders.  Therefore reduction in stress will have a positive affect on chronic pain in fibro patients.

Role of Stress and Trauma

FM stress

FM stress

Research has found that stress plays a large role in causing fibromyalgia.  Increased stress and abnormal response to that stress has been found to affect health;  there is a strong correlation that fibro patients perceive high levels of stress.



On my initial exam I found that most patients noticed onset of chronic pain following some form of trauma. Most report a history of motor vehicle accidents, sexual assaults, domestic violence and workplace hostility.  

I found various occupations that consistently had a high incidence of chronic pain symptoms.  These included;  but were not limited to receptionist and jobs that required long periods of sitting at a desk looking at computer monitors, etc.  Beauticians and jobs that required long periods of static standing with arms elevated frequently lead to chronic pain.  Customer relations and jobs that involve working with unsatisfied people often lead to stressful situations.  

High stress reactivity precedes the development of fibro symptoms.

Peripheral Pain Pathways


The following discussion is for the readers that want more technical explanations.  I will try to tone it down; but I feel it is needed to dispel the assumption that the cause of fibromyalgia is “just your imagination”.

Chronic pain is felt in deep tissues including muscles.  It is related to sensitization of pain pathways in the central (spinal cord and brain) and peripheral (outside the spinal cord) nervous systems.  Substance P is a chemical substance in the brain. It is the “pain messenger”.


Pain Pathway

Excessive levels of Substance P can cause pain signals to be sent to the brain even when there is no reason for such a signal to be sent (no injury, illness, or trauma).  The cerebral spinal fluid (CSF) of fibro patients has been tested and elevated levels of Substance P have been identified.

To matters worse, elevated levels of Substance P can induce cytokines, which will make peripheral nerves more sensitive.  You guessed it; elevated levels of cytokines in fibro patients have been detected in blood and skin samples.

Your chronic stress from any number of “triggers” has resulted in your nerves becoming more sensitive than normal.  These pain sensors keep firing pain messages to the brain even when not being stimulated.  This results in chronic pain that causes a “snow ball” effect causing more symptoms.


The perfect storm

You have become the victim of a “perfect storm”.