As you can imagine, in my brick and mortar practice I was asked 'What causes fibromyalgia pain?' many times.

Nearly everyone hopes the answer comes quickly and the resolution swift.

The National Institutes of Health (NIH) continues to state that the cause of fibromyalgia is unknown.

They suspect that the following events may play a role in this pain-filled disease:

• physical trauma
• emotional trauma
• abnormal responses to pain
• long-term sleep disturbances

There are a few diseases that mimic some of the symptoms of fibromyalgia. These diseases include:

• Sleep Apnea
• Lyme Disease
• Hypothyroidism
• Auto-immune disorders (Lupus, Rheumatoid Arthritis, etc.)

Since there is no known 'medical' cause for fibromyalgia, there is no lab test to diagnose this disease. No blood test or urinalysis to confirm the presence of this disease.

While patients feel significant joint pain, there is no joint abnormality seen on X-Ray or MRI. Fibromyalgia is not an inflammatory disease, which is why the joints are intact.

The clinical diagnosis can only be made after all other diseases have been excluded.

This is problematic for many reasons. The unfortunate truth is that many people go to their primary care physicians with complaints of wide-spread pain and instead of looking to see what the real cause may be, a prescription is written and the patient walks out the door. This not putting blame on the primary care physician. Many patients walk in wanting and expecting a prescription for medicine. Patients don't necessarily want to go through a battery of tests to rule in or rule out diseases. They just want to take a pill that will make the pain go away.

Changes need to happen on both side of the table. The physician (in a perfect, non-insurance world) would take the time to talk with a patient and explain, in as much detail as is necessary, the different reasons the patient has wide-spread pain. The physician would not give in to the patient's request for a prescription and a skip out the door.

The patient, in a perfect world, would feel empowered to ask questions. To ask for full explanations about other possible reasons for the wide-spread pain.

It is a very unfortunate scenario when a patient with another disease process (Lyme, Auto-Immune, Hypothyroidism, etc) is brushed aside and not listened to.

It happens all too often. The broad diagnosis of fibromyalgia is given and the prescriptions are written. The patient walks out the door and the real cause of the pain has not been uncovered. All the while, the 'real' cause is continuing to wreak havoc on the body while a 'band-aid' medicine is being taken.

The upshot of this article, make sure that you've exhausted all possible explanations of your pain. Pain is a 'warning signal' and your body would not be sounding the alarm for no reason. If there is pain, there is a reason.

Let's start at the beginning. Let's look at foundational causes that may be preventing the body from processing pain signals efficiently.

There is, for certain, a cause of fibromyalgia....

Everything in nature has a cause and effect.

My next article will address the treatment options for fibromyalgia. It is perplexing. It is baffling. As always, I want to empower patients to take charge of their health.