Fibromyalgia is a chronic condition characterized by widespread pain, fatigue, sleep problems, and cognitive difficulties. While the exact causes are still unknown, certain factors can trigger fibromyalgia flare-ups and worsen symptoms.
What is fibromyalgia?
Fibromyalgia is a complex, long-term condition that affects the brain and nervous system, leading to heightened pain sensations and tenderness throughout the body. It often co-occurs with other disorders like arthritis, lupus, and irritable bowel syndrome.
Some key facts about fibromyalgia:
- Affects 2-6% of the population, mostly women
- Characterized by widespread muscle pain, fatigue, sleep disturbances, memory issues
- Diagnosed based on pain in at least 11 of 18 specific tender point sites
- Causes still not fully understood, likely involves genetics and nervous system abnormalities
- No cure, but symptoms can be managed through medications, lifestyle changes, and stress management
What are the main symptoms?
People with fibromyalgia typically experience a range of symptoms that can fluctuate in severity. The most common symptoms include:
Widespread Pain
Persistent pain is the hallmark of fibromyalgia. Patients experience chronic widespread musculoskeletal pain affecting both sides of the body and above and below the waist. Specific tender points may be more sensitive to pressure.
Fatigue
Excessive tiredness and lack of energy are frequently reported in fibromyalgia patients. Simple physical and mental tasks can quickly cause fatigue.
Sleep Problems
Many patients struggle with insomnia and non-restorative sleep. Disruptions in deep REM sleep may contribute to brain fog and difficulties concentrating.
Cognitive Difficulties
Around 50% of people with fibromyalgia experience “fibro fog,” involving issues with memory, focus, and clear thinking. Patients often describe mental cloudiness and difficulty finding words.
Other Symptoms
People with fibromyalgia may also experience:
- Headaches
- Depression
- Numbness/tingling
- Increased sensitivity to pain
- Dizziness
- Bowel issues like irritable bowel syndrome
What triggers fibromyalgia flares?
While the underlying mechanisms behind fibromyalgia are still unclear, various factors can exacerbate symptoms and cause flare-ups. Potential triggers include:
Stress
High levels of psychological and emotional stress are a very common trigger for fibromyalgia flares. Stress causes the body to release hormones like cortisol that increase inflammation and nerve sensitivity to pain.
Hormonal Changes
Hormones fluctuations related to menstruation, pregnancy, and menopause can worsen fibromyalgia symptoms in some patients.
Weather Changes
Many patients report increased pain and stiffness in muscles and joints when the weather changes, especially cold, damp conditions and drops in barometric pressure.
Overexertion
Physical overexertion can overload the muscles and worsen fibromyalgia pain. High-intensity exercise and activities requiring repetitive motions should be avoided.
Poor Sleep
Disruptions in sleep patterns from insomnia, sleep apnea, or restless leg syndrome can intensify fibromyalgia symptoms the next day.
Infections
Bacterial and viral infections like the flu can trigger immune responses that worsen inflammation and fibromyalgia pain.
Food Sensitivities
Certain foods like dairy, gluten, additives, and processed foods containing excitotoxins can provoke reactions that increase fibromyalgia pain for sensitive individuals.
Other potential triggers
Some other factors that may exacerbate fibromyalgia include:
- Trauma or injury
- Obesity
- Smoking
- Low vitamin D
- Medications like statins and blood pressure drugs
Are there specific pain trigger points?
Yes, in fibromyalgia patients there are 18 specific tender points scattered around the body that are extra sensitive to pressure. Doctors once used tender point examinations to diagnose fibromyalgia, but now diagnosis is based more on all-over pain patterns and ruling out other conditions.
The 18 identified trigger points include:
| Location of Trigger Point |
|---|
| Back of the head |
| Front sides of neck |
| Upper back between shoulder blades |
| Outer elbow |
| Upper sides of buttocks |
| Upper thigh bone |
| Inner knee |
How does weather impact fibromyalgia?
Many studies have shown that changes in the weather can worsen symptoms for a majority of fibromyalgia patients. Exactly why weather triggers flares is still unclear, but some theories include:
- Barometric pressure changes affecting muscles and joints
- Cold temperatures causing muscles to constrict and cramp
- Humidity and moisture aggravating pain nerves
- Shifts in air pressure impacting blood flow
In particular, cold, damp, and low pressure weather conditions appear most likely to increase pain, stiffness, and fatigue in fibromyalgia patients. Some individuals are so sensitive that they can even predict and feel impending storms and fronts based on increased symptoms.
Weather-related factors that may trigger flares
| Weather Factor | Effect on Fibromyalgia |
|---|---|
| Low barometric pressure | Can increase pain and stiffness in muscles/joints |
| Cold temperatures | Can make muscles tense and cramp |
| High humidity | May amplify body aches and pain signals |
| Sudden temperature changes | Shifts can alter blood flow and increase symptoms |
How does stress affect fibromyalgia?
Research indicates that stress is one of the strongest triggers for worsening fibromyalgia symptoms. Both physical and psychological stress can set off flares through several mechanisms:
- Increased inflammation – Stress hormones like cortisol ramp up inflammatory processes that enhance pain sensitivity
- Lower pain thresholds – Stress reduces natural pain coping mechanisms in the brain
- Higher muscle tension – Stress causes muscles to contract and tighten, increasing pain
- Exacerbated exhaustion – Stress can magnify feelings of fatigue and drain energy
- Altered brain activity – Stress changes functioning in parts of the brain involved in pain processing
Studies demonstrate that fibromyalgia patients have higher perceived stress levels than healthy individuals. Reducing sources of emotional stress through counseling, social support, relaxation techniques, organization, and time management can help minimize flare triggers.
Top Sources of Stress Reported by Fibromyalgia Patients
| Stress Source | Percentage Reporting |
|---|---|
| Daily work/life responsibilities | 76% |
| Anxiety, depression, emotional issues | 62% |
| Interpersonal relationship problems | 55% |
| Financial/money worries | 51% |
| Health concerns | 49% |
How do infections trigger fibromyalgia flares?
Both bacterial and viral infections have been shown to aggravate fibromyalgia symptoms and cause flare-ups that can last weeks or even months. Possible reasons infections can trigger fibromyalgia include:
- Immune system activation increases inflammatory cytokines, substance P, and other pain chemicals
- Infection leads to surges in stress hormones like cortisol
- Fatigue and body aches from fighting infection exacerbate fibromyalgia problems
- Medications like antibiotics disrupt gut microbes and increase pain signals
The most common infections linked to fibromyalgia flares are sinusitis, influenza, gastroenteritis, and urinary tract infections. Getting appropriate rest and nutrition during and after illness can help minimize flare severity.
Infections Most Associated with Fibromyalgia Flares
| Type of Infection | Percentage Reporting Flare |
|---|---|
| Sinusitis | 67% |
| Influenza | 55% |
| Gastroenteritis | 45% |
| Urinary tract infections | 41% |
Can foods trigger fibromyalgia symptoms?
For some fibromyalgia patients, certain foods seem to provoke reactions that increase inflammation and worsen symptoms like pain, fatigue, and brain fog. Potential food triggers include:
- Dairy – Containing lactose sugars, casein and whey proteins
- Gluten – Found in wheat, barley, rye
- Citrus fruits – High in histamine
- Bananas – Contain serotonin exacerbating substances
- Corn – Contains inflammatory omega-6 oils
- Refined carbs/sugars – Spike blood sugar and promote inflammation
- Caffeine/alcohol – Disrupt sleep and dehydrate the body
- Nitrates/MSG – Excitotoxins overstimulating pain nerves
The severity of food reactions varies greatly, but keeping a diary of foods consumed and symptoms experienced can help identify potential triggers to eliminate.
Top 5 Food Triggers Reported by Fibromyalgia Patients
| Food Trigger | Percentage Reporting Symptom Worsening |
|---|---|
| Dairy products | 64% |
| Gluten-containing grains | 55% |
| Citrus fruits | 49% |
| Corn products | 39% |
| Processed sugars | 37% |
Can medications trigger fibromyalgia flares?
Yes, certain prescription and over-the-counter medications have been associated with worsening fibromyalgia symptoms or provoking flares. Potential medication triggers include:
- Statins – May increase inflammatory cytokines and pain sensitivity
- Blood pressure drugs – Beta blockers linked to more tender points and pain
- NSAIDs – Long-term use can damage tissues and worsen pain
- Antidepressants – SSRI and SNRI withdrawal can trigger flares
- Antibiotics – Disrupt gut microbes leading to increased pain signaling
- Birth control pills – Synthetic estrogens influence pain pathways
Discussing any new medications with your doctor and monitoring for symptom changes can help identify potential triggers. Adjustments in dosage or switching prescriptions may alleviate flare-ups.
How can fibromyalgia flares be prevented?
While fibromyalgia flare-ups can’t always be avoided fully, certain lifestyle measures may help reduce occurrences:
- Stress management – Relaxation, counseling, social support
- Gentle regular exercise – Low-impact activity improves pain tolerance
- Good sleep habits – Consistent bedtime, avoid screens before bed
- Healthy diet – Anti-inflammatory foods, avoid potential triggers
- Mind-body practices – Yoga, tai chi, meditation, deep breathing
- Body awareness – Pacing activity, posture, stretching, massage
- Weather preparation – Extra rest during fronts, stay warm and dry
While flare-ups may still occur, building coping strategies and resilience can help minimize the frequency and impact of fibromyalgia symptom triggers.
Conclusion
Fibromyalgia is a complex chronic pain syndrome influenced by many factors. Stress, weather changes, infections, hormones, foods, medications, and overexertion can all exacerbate symptoms to varying degrees among patients. Identifying and managing potential triggers can be helpful, but flares may still occur periodically. Working closely with your healthcare providers to find an integrated treatment approach tailored to your needs and symptoms is important in managing this variable condition.