Chronic physical pain may seem like it should have a physical cause, but a growing body of evidence suggests the link between fibromyalgia and trauma may be both physical and psychological.

Fibromyalgia is a chronic disorder featuring transient musculoskeletal pain and tenderness throughout the body. Fibromyalgia can affect anyone of any age, but you’re more likely to develop it as you grow older and if you were assigned female at birth.

The exact processes behind fibromyalgia aren’t well understood. Fibromyalgia isn’t considered an autoimmune disease, joint or muscle disorder, or an inflammatory condition.

Currently, fibromyalgia is accepted as a disorder of heightened pain sensitivity, and research suggests your body’s response to trauma may have something to do with the disorder.

The exact causes of fibromyalgia aren’t clearly understood, but trauma — physical and psychological — may be among them.

A 51-study review from 2018 found the majority of people living with fibromyalgia reported a significant association between the onset of symptoms and the experience of emotional or physical trauma.

The quality of the data pool was too low to draw further conclusions, but experts noted emotional trauma was more common than physical trauma.

Why does it happen?

How a state of overwhelm translates to chronic pain may have to do with how your body reacts when faced with extreme distress.

Research shows trauma creates a sequence of neurobiological responses that can affect brain structures, change neurological synapses, and potentially alter gene expression.

Pain in fibromyalgia may change central nervous system communication. Your altered neural pathways then may skew pain perception and contribute to other regularly seen symptoms such as cognitive impairment, sleep disturbance, and fatigue.

Is fibromyalgia related to childhood trauma?

Language matters

You’ll notice that the language used to share stats and other data points is pretty binary, especially with the use of the word “women.”

Although we typically avoid language like this, specificity is key when reporting on research participants and clinical findings.

Unfortunately, the studies and surveys referenced in this article didn’t report data on, or include, participants who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.

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Fibromyalgia isn’t exclusively related to childhood trauma, but childhood traumatic events (CTEs) may be linked to fibromyalgia.

A small 2018 study of 136 women found CTEs were significantly more common among those living with fibromyalgia.

In 2020, a large-scale population-based study found mistreatment in childhood is associated with a 2.06 times higher risk of developing fibromyalgia later in life.

Another small study of women from 2022 found 88.2% of those living with fibromyalgia had experienced childhood trauma.

Researchers believe when you’re exposed to major stress during your youth, the way your stress response develops can be negatively affected, increasing your vulnerability to stress-related disorders.

Post-traumatic stress disorder (PTSD) is a mental health disorder directly associated with experiences of trauma. PTSD involves symptoms of re-experiencing, avoidance, and emotional reactivity.

While chronic physical pain isn’t a defining symptom of PTSD, these two disorders often occur simultaneously.

A small 2020 study found PTSD was associated with major clinical fibromyalgia symptoms, and most people in the study living with fibromyalgia reported PTSD symptoms before chronic pain was diagnosed.

It’s not clear if fibromyalgia is a manifestation of chronic pain in PTSD, if PTSD makes existing fibromyalgia worse, or both.

Not all people living with fibromyalgia report trauma before the symptoms occur. The 2020 study also found some people who noticed pain sensitivity before traumatic experiences, as early as childhood, which was made worse after the event.

As many as 50% of people with fibromyalgia are living with anxiety or depression at the time of their fibromyalgia diagnosis. Mental health conditions are so common that they’re considered a primary sign of fibromyalgia.

It’s natural to experience rapid mood changes when you’re living with chronic pain. If fibromyalgia prevents you from doing things you enjoy and gets in the way of basic functions, keeping a positive mindset can be a challenge.

Feeling anxiety and depression because of fibromyalgia is just one way this disorder affects your mood.

Research also indicates that extreme feelings of sadness, fear, anger, and guilt may be more common in fibromyalgia due to changes in the brain that increase pain sensitivity.

This means if you’re more sensitive to pain stimuli, your emotional responses may also be more intense. Something that’s sad for anyone, for example, may lead you to increased distress or upsetting thoughts.

Symptoms of fibromyalgia

Experiences of fibromyalgia can be different among people. Generally, symptoms include:

  • chronic widespread pain throughout the body
  • aching, throbbing, or burning sensations
  • persistent fatigue
  • difficulty sleeping
  • gastrointestinal issues
  • difficulty concentrating (known as “fibro fog”)
  • poor memory
  • sensitivity to temperature, sound, light, and odor
  • numbness in the extremities
  • tenderness to touch
  • joint and muscle stiffness
  • anxiety
  • depression
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Due to the variety of fibromyalgia presentations and a lack of insight into its exact causes, no standard fibromyalgia treatment exists.

Managing symptoms with medication alone may not work for the majority of people. Successful treatment plans typically involve a multidisciplinary approach, including:

Fibromyalgia occurs alongside many other physical conditions. The disorder is commonly seen in people also living with irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), and chronic headaches. Treating these conditions is also a part of fibromyalgia treatment.

Immunology and genetic therapies are also being investigated for use in fibromyalgia, even though it’s not currently considered to be genetic or autoimmune.

A doctor will create a custom plan based on your specific symptoms and medical history.

Changes in your central nervous system may be the link between fibromyalgia and trauma. When your body enters survival mode, it can create long-term changes in your brain’s function and structure that increase pain sensitivity.

Not everyone with trauma will develop fibromyalgia, and not all people living with fibromyalgia have a history of trauma.

Trauma is just one of the many potential causes identified in fibromyalgia research. Due to the vast array of clinical presentations, a multidisciplinary and custom treatment approach for fibromyalgia is generally necessary.