Post-traumatic Stress Disorder and Fibromyalgia

A Processing Disorder

The medical community first coined the term fibromyalgia in the year 1976 from a collection of four Latin root words that combine to connote a condition of pain in the muscles and fibrous tissue. More recent research may cause the term to become outdated, since the newest thinking is that the disease is not so much in the muscles as it is in the nervous system and in the brain. Medical researchers now believe that a combination of metabolic, endocrine, and immune system abnormalities are the key components of the syndrome, making it more of a processing disorder than a muscle disease.

While fibromyalgia got its name in 1976, the American Medical Association (AMA) only acknowledged the condition as a real disease in 1987. Prior to such classification, fibromyalgia sufferers had been unable to claim disability payments for their very real symptoms which often made it impossible to work. These gains are significant, but remain far from the goal of discovering a definitive cause for the collection of varied symptoms that may arise with FM. Some believe that the causes of the disease have their origins in physical abnormalities, while others believe that psychosocial factors are at least contributory issues in the development of fibromyalgia.

Of late, there has been an examination of the relationship between abuse, chronic stress, post-traumatic stress disorder (PTSD) and the subsequent development of fibromyalgia. PTSD was categorized even later than fibromyalgia, having first been classified as a bonafide mental illness only in 1980. While that initial categorization of the disorder proved to be limited and somewhat naïve, today, after two revisions, the Diagnostic and Statistical Manual of the American Psychological Association (DSM) defines PTSD as arising in response to life-threatening events, the witnessing  of violent acts, or the sudden or violent death of colleagues or friends. Included in the definition of traumatic events that can spur the disorder are sexual or physical assault, combat, imprisonment, being held hostage, being victimized by terror, experiencing torture, living through manmade or natural disasters, being in an accident, or receiving the news that one has a terminal illness.

Some studies show that many sufferers of PTSD tend to develop fibromyalgia. Researchers think that the correlation may be due to the physiological changes that occur in the HPA axis in both syndromes. HPA stands for hypothalamus, pituitary, and adrenal, and the three components are responsible for our hormonal response to stress. When these systems work in smooth tandem, the body remains stable under stress. The hypothalamus gives off hormones that cause the pituitary gland to secrete another hormone, and this causes the adrenal gland to manufacture cortisol, which is needed to balance our response to stressful events.

Compelling Evidence

Subtle alterations of the HPA axis occur in PTSD patients, in fibromyalgia patients, and also in chronic fatigue syndrome, yet another set of symptoms which often coexists with fibromyalgia. This alteration in the body's HPA axis in these three syndromes is compelling evidence that chronic stress plays a role in the subsequent development of fibromyalgia.

 

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