Is Fibromyalgia an Autoimmune Disease?
According to statistics, fibromyalgia affects approximately 5 million people in the United States. Many people tend to believe that fibromyalgia is an autoimmune disease; while others do not – this can be quite confusing to an individual’s afflicted with this condition.
In this article, we’ll dive into the details of fibromyalgia so that you can learn the truth about whether it is, in fact, an autoimmune disease so that you can gain a better understanding of this disorder.
What Is Fibromyalgia?
Fibromyalgia is a disorder that characteristically involves widespread musculoskeletal pain that researchers believe is the result of amplified pain sensation caused by the way the brain processes pain signals.
The mechanism of faulty pain signal processing is believed to be the result of repeated stimulation of nerves that causes changes within the brain. The changes that occur in the brain include an abnormal increase in neurotransmitters that signal pain, as well as an increased sensitivity to pain causing an increased reaction to pain signals.
In addition to widespread muscle pain, other symptoms of fibromyalgia include fatigue and cognitive difficulties or the so-called “fibro fog” – a condition in which the patient suffers from impaired focus and concentration.
Some cases of fibromyalgia develop slowly over time with no triggering event, while symptoms begin in some individuals following surgery, physical trauma, infection, or severe psychological stress.
In many cases, individuals suffering from fibromyalgia also have additional painful conditions, including irritable bowel syndrome (IBS), migraines, temporomandibular joint (TMJ) disorders, and interstitial cystitis, as well as psychological disorders including depression and anxiety.
Fibromyalgia is often a debilitating condition and it’s important that affected individuals be monitored regularly so that they receive the necessary treatment to help manage their symptoms. Options for fibromyalgia treatment include a combination of medications, pain relievers, physical therapy, occupational therapy, and lifestyle changes such as stress reduction and exercise.
There is not one single treatment plan that works for every patient - there are a variety of different treatment combinations, depending on the severity of a patient’s symptoms, and sometimes it takes a little trial and error to find the right treatment combination to provide adequate symptom control.
What Is an Autoimmune Disease?
As the term suggests, an autoimmune disease is a disease in which, for some reason, the body starts to mistake its own tissues for foreign ones and naturally takes the necessary steps towards their elimination so that balance and wellbeing can be restored. The body creates autoantibodies, which attack these healthy tissues, and the attack itself causes damage to these tissues, resulting in inflammation.
Common autoimmune diseases include rheumatoid arthritis, lupus, Sjogren's syndrome, psoriasis, scleroderma, and many others. Autoimmune diseases are unfortunately not curable, and treatment only helps to control the symptoms so that the patient can enjoy a more comfortable quality of life, despite the fact that they are suffering from an autoimmune disease.
Is Fibromyalgia an Autoimmune Disease?
Fibromyalgia was once considered to be an arthritis-related condition, similar to rheumatoid arthritis, which is a well-known autoimmune disease, so researchers just assumed that fibromyalgia should be categorized the same. However, while this was the original assumption of researchers, there is evidence to suggest that fibromyalgia is not actually an autoimmune disease.
A key factor in autoimmune diseases is high inflammatory markers found in laboratory testing. This is because, with autoimmune diseases, the body recognizes its own tissues as foreign ones and later attacks them causing inflammation to develop. If fibromyalgia was an autoimmune disease, high levels of inflammatory markers would be expected on testing; however, laboratory tests actually show low inflammatory markers in patients with fibromyalgia.
An example is an antinuclear antibody (ANA) test – individuals with fibromyalgia typically have levels that fall below the diagnostic threshold, with their levels being within the normal range. That being said, their levels may be on the high end of normal, but they’re not high enough to warrant an autoimmune diagnosis.
While anything above 0 on the ANA test signals inflammation in the body, autoimmune diseases have a particularly high level on this test. Additionally, researchers have found little evidence of cellular damage at the site of immune system activity in patients suffering from fibromyalgia.
Where testing results become complicated is when patients suffering from fibromyalgia are also afflicted with an autoimmune disease, resulting in inflammation and high inflammatory markers on laboratory testing.
Often times, before the autoimmune disease is diagnosed correctly, the symptoms, especially the inflammatory process, are thought to be caused by fibromyalgia, creating the illusion that fibromyalgia is an autoimmune disease, when in fact, research suggests otherwise.
Some preliminary existing research may re-focus expert studies back in that direction eventually. One such study shows that certain nerve structures, including the optic nerve, are sometimes damaged in fibromyalgia. So far, we don't know why or how prevalent this damage is. That means we don't yet know whether this is evidence of autoimmunity. It's certain to be looked at as one possible cause, though.
Autoimmune Disease vs. Fibromyalgia
Fibromyalgia is often difficult to diagnose because the symptoms are similar to a variety of other conditions, including some autoimmune diseases. It’s also not uncommon to have fibromyalgia and an autoimmune disease simultaneously, which further complicates the diagnosis process.
The biggest difference is the fact that in patients diagnosed with fibromyalgia, no traces of inflammation or high inflammatory markers can be found on laboratory testing, which not the case with any of the autoimmune diseases where high inflammatory markers are expected and found on laboratory testing.
Is Fibromyalgia an Autoimmune Disease or Not?
Although there are still people around the world who want to prove the opposite, until research suggests otherwise, the current evidence suggests that fibromyalgia is not an autoimmune disease. However, the fact that it is not an autoimmune disease does not mean that individuals with this disorder should not be taken seriously.
If you’re suffering from symptoms of fibromyalgia, consult with your physician to determine the best treatment options so you can enjoy an optimal quality of life.