Onset of Fibromyalgia is an interesting topic. It generally seems to me that most cases seem to be from trauma, illness or accident and sudden onset. In my case, there was no such event and it was gradual onset. I suspect it was because I had hypermobility syndrome that already was causing chronic pain and insomnia, and that is comorbid with fibromyalgia. Sort of made for the perfect conditions for another chronic pain condition. However, it also runs in my immediate family as my father also has fibromyalgia. I was diagnosed at age 21 I believe and my father I believe in his mid-thirties. It took me years to actually be diagnosed as I saw my first rheumatologist when I was 16 and he had written in his notes, not that I was aware of this, that I was developing FM. So I assume I had indications of this but due to the gradual onset, not enough for him to definitively declare it.
The Healio reported of the patients with FM about a quarter reported a precipitating event such as trauma, infection. The study looked at 978 patients using the Fibromyalgia Impact Questionnaire (FIQ) and SF-36. They were asked about precipitating factors in their history and whether their symptoms were sudden or gradual in onset.
- 295 subjects reported a precipitating trauma prior to onset.
- 203 of them reported their preceding factor was physical trauma. ( car accidents, childbirth, falling).
- 53 said infection was the factor of onset (Epstein-Barr, Borrelia burgdorferi, varicella zoster.
- 87.5 reported sudden onset. Compared with 5.9% of the idiopathic patients (no precipitating trigger event)
Healio: Time to diagnosis was shortest in the group that reported infection at mean 43.3 months compared with 101 months in the patients with idiopathic FM and in 98.5 months in the group that reported trauma.
Patients who reported physical trauma had worse FIQ scores than other groups, and patients who reported infection reported worse physical functioning on the FIQ; however, adjustments for marital status and disease duration showed no significant differences in FIQ score and patient-reported infection, according to the researchers.
Significant differences were seen between the three groups for the SF-36 physical and mental component summaries and mental health index. Worse SF-36 physical functioning was seen in patients with precipitating infection, but better role emotional and mental health index were seen in the same patients, the researchers found.
“In this study, differences between those in the trauma and idiopathic groups were limited to more sudden onset and worse FIQ physical functioning in the trauma group,” study researcher, Terry H. Oh, MD, told Healio.com/Rheumatology. “Those findings contradict previous findings of no difference in FIQ physical functioning between patients with and without traumatic onset but agree with more reduced physical activity in patients with traumatic onset. Similar frequency of precipitating illness or infection has been reported previously in patients with fibromyalgia.”
My onset story is pretty tangled up with the hypermobility syndrome due to the fact some of the symptoms are similar. It is hard to say really when my true onset actually was. I did have symptoms of pain, fatigue, and insomnia very young but all of them could have been the joint hypermobility syndrome. When I did go to the doctor when I was 20, it was because everything had got so much more severe over time. Pretty much progressing hard since I was 16. By the time I was 18 I had a hard time coping with it all. Onset due to a comorbid condition though isn’t mentioned in this study. Although it can happen often. People with migraine can have comorbid FM that develops after the migraine, for example, I just went the other way around.