Many Fibromyalgia physicians believe there are precipitating factors that lead to the onset of fibromyalgia.
Primary fibromyalgia occurs spontaneously in individuals not suffering from any related or triggering condition. There is no clear cause for “primary fibromyalgia,” but over time the severity of primary fibromyalgia is affected by factors such as sleep deprivation, muscle atrophy, emotional stress, coping style, the weather, and of course, the pain itself. The course tends to be chronic, with unpredictable periods of greater and lesser severity.
Secondary fibromyalgia occurs in patients whose pain was preceded or triggered by another illness, such as arthritis, bursitis, or lupus, or from abnormal structural conditions such as disc tears and herniations, and nerve entrapments. The course and appearance of secondary fibromyalgia is very similar to primary fibromyalgia. The picture is complicated because the patient’s other illness or illnesses continue to cause symptoms and require treatment. It is often a difficult medical challenge to know when a triggering factor, such as a disc herniation, should be addressed surgically or whether other pain control methods should be pursued. A great many patients with fibromyalgia respond poorly to surgery, so it has been suggested by some experts that, for fibromyalgia patients, nonsurgical options should be the first course of action when conditions permit.