Is Fibromyalgia Hereditary? Exploring the Genetic Connection in Chronic Pain

Is fibromyalgia something you can get from your family?

Scientists have found that the genes you inherit from your parents do play a big role. If you have fibromyalgia, it's pretty likely that someone in your family might have it too. But it's not all about genes – about half of the chance of developing fibro comes from environmental factors and experiences.

In this article, we will talk about the role of genetics and inheritance patterns on your likelihood of being diagnosed with fibromyalgia.

We will also explore the environmental factors and other risk factors, such as your gender, and dive into epigenetics' role in all of this. We'll equip you with strategies to manage any fibromyalgia symptoms as well.

The role of genetics in fibromyalgia

Developing fibromyalgia is not just a random occurrence. Research shows that there is a genetic predisposition to this chronic pain condition¹. The tendency to develop fibromyalgia has been linked to specific genetic markers that affect the body's systems responsible for serotonin, dopamine, and catecholamine – all of which are integral to how we process and experience pain.

Key genes being investigated for their role in fibromyalgia include:

• 5-HT2A (serotonin receptor) – this gene plays a role in the regulation of mood, anxiety, and the sleep-wake cycle².
• 5-HTT (serotonin transporter) – this gene is responsible for helping regulate serotonin levels in the brain and is implicated in mood disorders³.
• COMT (a gene for catecholamine inactivation) – the COMT gene provides instructions for making an enzyme that breaks down certain neurotransmitters, including dopamine, epinephrine, and norepinephrine. This process is crucial for the normal functioning of the nervous system⁴.
• D4 dopamine receptor – this gene encodes a receptor for dopamine, another neurotransmitter that influences many functions including mood, reward, and motor control. Variations in this gene can affect behavior and cognitive processes⁵.

Genome-wide association studies have pinpointed genetic variants that are associated with widespread musculoskeletal pain, further cementing the role of genetics in chronic widespread pain, a condition closely related to fibromyalgia⁶.

Inheritance patterns & familial risk

The genetic link means that fibromyalgia can run in families. This means that if you have a parent or sibling who lives with fibromyalgia, your risk of developing the condition is much higher than that of the general population. Some research has shown that 28% of people whose mother has fibro also have the condition⁷, compared to about 2% of people who do not have a close family member with fibro.

While genetics can significantly elevate someone’s likelihood, having familial ties does not mean you definitely will for developing fibromyalgia, due to other variable risk factors at play⁸.

Environmental factors & triggers

If you have a family history of fibromyalgia it might mean that you have inherited that genetic predisposition, making you more prone to getting fibromyalgia. If life then throws particular challenges at you, these events can interact with your genes and potentially set off fibromyalgia.

Put another way, think of fibromyalgia as being like a puzzle, in which genetics provides some of the picture and your environment and experiences also add pieces.

Sometimes, something big such as a serious injury, illness, operation, or stressful life event can trigger fibromyalgia. In some cases, it's challenging early life experiences, for example physical trauma or psychosocial stressors, that can elevate someone’s susceptibility for fibromyalgia.

But it doesn't have to be a big event. Fibro symptoms can sneak up slowly and without a clear starting point. Someone might wake up one day and realize that they've been feeling tired and achy for a while, but be unsure when it all began.

Events that cause a lot of stress can interfere with your hypothalamic-pituitary-adrenal (HPA) axis⁹, which is the interaction between the hypothalamus (part of your brain) and your pituitary and adrenal glands to control your stress response, such as the release of hormones. If this becomes disrupted, the result can be feeling pain more intensely and in response to stimuli that wouldn't normally cause such discomfort.

Epigenetics & fibromyalgia

The complexity of fibromyalgia, influenced by both genetic and environmental factors, is compounded when we consider epigenetics. We use the word epigenetics to describe environmental factors that can turn certain genes on or off, without changing the actual DNA you were born with. Think of it as a dimmer switch for lights – it can make a room brighter or darker, but it doesn't change the color of the walls.

Research has found that certain genes are affected in people with fibromyalgia, and these changes might impact signals that tell the body how to repair DNA, control the immune system, or move substances across cell membranes^10,11. In particular, scientists are currently investigating the impact of the genes BDNF, NAT15, HDAC4, PRKCA, RTN1 and PRKG1.

Other risk factors for fibromyalgia

There are other risk factors outside of our inherited genes. These include:

• Gender – women are more likely to develop fibromyalgia than men, possibly due to hormonal differences or social stress factors.
• Age – while it can occur at any age, fibromyalgia is most commonly diagnosed in middle age, and risk increases with age.
• Sleep abnormalities – disruptions in normal sleep patterns are not only symptoms but also potential risk factors for developing fibromyalgia.
• Autoimmune disorders – people with disorders such as rheumatoid arthritis or lupus may be more prone to developing fibromyalgia.
• Mental health issues – there is a strong correlation between fibromyalgia and conditions such as depression and anxiety, though the nature of this relationship is complex and bidirectional.

What is the life expectancy of a person with fibromyalgia?

Many people who are diagnosed with fibromyalgia wonder if their condition could shorten their lifespan. Fortunately, fibromyalgia does not have a direct impact on lifespan.

The severity of symptoms can vary widely from person to person and may fluctuate over time – sometimes they worsen, while at other times they might subside significantly. Complete remission is rare.

How to treat fibromyalgia symptoms

The management of fibromyalgia symptoms entails a multifaceted approach that includes medicinal treatments, lifestyle changes, and non-medication-based therapies.

Retraining your pain response

To learn how to handle pain better, you need to know that pain isn't just about how much something physically hurts. It's also about your feelings, thoughts, and what's happening around you.

If you figure out what makes your pain worse, you can start to work on managing those aspects of life. You might change what you eat, get better sleep, or move more. Learning about the true nature of pain can also help change the way your brain deals with pain, and by working on this regularly, you can train your system to experience less pain over time.

Stress management

Stress hormones, such as cortisol, can increase the pain your experience. While it's not always possible to stay away from stress, there are things that can help you deal with challenging situation. Some ways to help you relax and feel less stressed are cognitive behavioral therapy (CBT), practicing mindfulness techniques, such as sitting quietly and focusing on your breathing, doing things that make you feel calm, and spending time with friends or people who understand what you're going through.

Movement & exercise

Engaging in physical activity can help to diminish pain, elevate your spirits and energy, and enhance the quality of your sleep. It’s important to customize your movement to fit your individual limitations and symptoms, and remember, it doesn't need to be structured exercise! Active pastimes such as yoga, dancing, or gardening are all beneficial.

We recommend two key strategies: begin gently and practice self-compassion. Initiate your journey with gentle, low-impact movements and incrementally increase both the intensity and duration to allow your body to adjust without risk. Remember, being compassionate towards yourself helps to face challenges with greater resilience and assurance.

Sleep quality

Sleep is a pivotal element in the battle against fibromyalgia symptoms, serving as a cornerstone of self-care practices aimed at mitigating pain. The relationship between sleep and fibromyalgia is a complex one; inadequate sleep can intensify fibromyalgia symptoms, while the symptoms themselves can lead to sleep disruption.

To mitigate the impact of fibromyalgia on your sleep and, by extension, on your symptoms, it's essential to enhance your sleep habits. Here are some suggestions for improving your sleep hygiene:

• Try to go to bed and wake up at the same time every day, and aim for about eight hours of sleep.
• Keep daytime naps short so they don't mess up your sleep at night.
• Be active during the day because it helps you fall asleep easier.
• Don't look at screens like phones or TVs right before bed so your brain can get ready for sleep.
• Make sure your bedroom is dark and quiet so nothing wakes you up.
• Don't have too much caffeine like in soda or coffee, especially later in the day, because it can keep you awake.
• Don't eat a big meal or drink alcohol right before you go to sleep because it can make it harder to sleep well.
• Besides sleeping, take little breaks to rest your heart, body, and mind to help you feel better and manage fibromyalgia.

Medication

Medicine can help you with your fibromyalgia symptoms, but it's not the only thing you should use. Think of medicine like a helper that makes it easier for you to do other things that can make you feel better. These other things include learning more about your pain, discovering simple changes to improve your nutrition and sleep, and getting support from people who understand what you're going through.

Some medications that doctors might give you for fibromyalgia include:

• pain relievers you can buy without a prescription, such as aspirin and ibuprofen
• antidepressants, such as amitriptyline and duloxetine, that can help with pain and wellbeing
• Low Dose Naltrexone (LDN) that can help control pain and swelling
• pregabalin and gabapentin, which can help to calm an overactive nervous system.

Always talk to your doctor to find out which medicine is best for you.

More information

At MoreGoodDays®, our commitment is to provide a comprehensive support system designed specifically for those coping with fibromyalgia. Our multidisciplinary strategy includes:

• providing educational materials and self-management strategies that offer deeper understanding of fibromyalgia and ways to alleviate symptoms
• offering advice on how to modify your lifestyle in terms of diet, physical activity, and sleep routines
• aiming to improve your wellbeing and life satisfaction overall.

We stand united in the journey towards fostering a more fulfilling life for you, notwithstanding the difficulties posed by fibromyalgia.

Download our mobile app for free from the Apple App Store or Google Play Store for immediate access to some of our content and to see your support options.