What are the recognized triggers for Fibromyalgia?
- Early life trauma: sexual or physical abuse.
- Acute trauma especially involving the trunk (cervical whiplash).
- Infections: Epstein–Barr virus, parvovirus, Lyme, hepatitis C.
- Sleep apnea.
- Chronic ongoing joint inflammation (secondary FM; prevalence in RA, SLE, and psoriatic arthritis ∼20%, in ankylosing spondylitis (AS) ∼10%–12%).
- Catastrophic events: posttraumatic stress disorder following war and other major events.
- Chronic psychologic distress.
Only a minority of patients experiencing one of these triggers develop a widespread pain syndrome, suggesting a biochemical predisposition.