Is Your Fibromyalgia Primary or Secondary?

Is Your Fibromyalgia Primary or Secondary?

Is Your Fibromyalgia Primary or Secondary?

This problem is going to sound odd to many. In fact, however, it is very applicable. What we really mean is this: is your fibromyalgia triggered by an unknown cause (hence primary) or has it evolved from a previous medical condition (hence secondary)?

Based on research to date, fibromyalgia can manifest from other medical conditions , especially those that are pain-related diseases. For instance, arthritis, rheumatoid arthritis ( RA), myofascial pain syndrome (MPS), multiple sclerosis (MS), lupus, irritable bowel syndrome ( IBS). Experts explain that the constant experience of pain in these conditions can cause changes in the perception of pain in our brain and nervous system, eventually leading to increased central sensitivity.


Fibromyalgia is a condition characterized by chronic musculoskeletal pain associated with fatigue, sleep, memory, and mood disturbances. While we still don’t know exactly what’s going on in the body that leads to fibromyalgia, we do know that chronic pain can cause changes in the brain and central nervous system that lead to central sensitization, essentially causing the body to overreact to pain and other stimuli (noise, smell, bright lights, etc.). That’s why people with rheumatoid arthritis ( RA), lupus, multiple sclerosis (MS) and other chronic pain conditions often develop FMS.

Why you need to know the category of your fibromyalgia?

The reason that you need to know whether your fibromyalgia is primary or secondary is it will decide the course of your care . For example, if you had myofascial pain syndrome before you were diagnosed with fibromyalgia, treating the symptoms of your primary medical condition, in this case it will be trigger points, can help to relieve the symptoms of fibromyalgia.

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Two categories of fibromyalgia

Fibromyalgia is divided into two categories : primary and secondary. Primary FMS is the most common and is also referred to as “idiopathic” FMS, meaning that it has an unknown cause. Secondary FMS has been linked with many sources of chronic pain.

1.  Primary (Idiopathic) Fibromyalgia

Suspected causes of primary FMS include brain and hormone disorders, persistent sleep disturbances, psychological and social effects, and muscle disorders. Work also aims in a variety of other ways, with varying achievements.

2.  Brain & Hormonal Abnormalities

Studies show that the parts of your central nervous system that deal with pain signals work differently from other people with FMS. This is called central awareness. Researchers know that people with FMS may have numerous abnormalities in their hormonal, metabolic and brain-chemical activity, but they are not sure whether these are the causes of fibromyalgia or the effects of pain and stress on the central nervous system. Some physical changes in the brain have also been discovered.

Norepinephrine & Dopamine: low levels

Low levels of norepinephrine may lead to loss of alertness, mental fog, depression, and apathy. Your body uses norepinephrine to make dopamine, and low dopamine results in muscle pain, further cognitive dysfunction, and movement-related problems (i.e. tremor, poor balance, clumsiness).

Causes of Secondary Fibromyalgia

Secondary fibromyalgia has similar symptoms to primary fibromyalgia. Potential causes of secondary fibromyalgia include:

• Physical injuries. For example, often secondary fibromyalgia occurs in people who have had neck injuries.

• Ankylosing spondylaritis. Ankylosing spondylitis is a form of chronic inflammation of the spine and sacroiliac joints in the lower back where the sacrum meets the iliac bones.

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• The surgery. Trauma, especially in the upper spinal region, may trigger the development of fibromyalgia.

• The disease of Lyme.

• Hepatitis C.

• Endometriosis.

Why people with fibromyalgia respond to different treatments or drugs differently

If your fibromyalgia is secondary and your primary medical condition is MPS, acupuncture or stretching therapy can work exceptionally well for you. However, fibromyalgia patients with rheumatoid arthritis as their primary medical condition may not be the result of the same two treatments. Instead, treating the characteristic RA inflammation with nonsteroidal anti-inflammatory drugs (NSAIDs) could work best for the latter. The above example could also explain why people with fibromyalgia respond differently to different treatments or drugs.

Primary vs. Secondary and Treatments

It is important to distinguish between primary and secondary when we talk about treatment. For example , some people have been successful with acupuncture in treating their fibromyalgia. It could be because acupuncture is one of the best treatments for the original condition of myofascial pain syndrome (MPS or CMP for chronic myofascial pain). While it is impossible to tell for sure whether acupuncture relieves the symptoms of fibromyalgia directly (some studies have shown that it can), or whether relieving the symptoms of MPS has had a secondary effect of relieving the symptoms of fibromyalgia.

Diagnosing secondary FMS

If there is another disorder at work, it can give doctors a real challenge when it comes to diagnosing secondary FMS. First, it may be difficult to figure out what condition causes the symptoms. Second, FMS is considered to be a diagnosis of exclusion because anything reversible has to be treated before a doctor can diagnose it. It’s important to find the root of your fibromyalgia, or rather what triggered your fibromyalgia. Discuss with your doctor if you have any underlying medical conditions or food sensitivities that may cause symptoms of fibromyalgia.

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Many medical conditions that triggers fibromyalgia can remain undiagnosed for years

Another reason why you should really be wondering whether your fibromyalgia is primary or secondary is that many medical conditions that trigger fibromyalgia may remain undiagnosed for years to come. This is because symptoms can blend seamlessly with a large pool of symptoms of fibromyalgia. Adrienne Dellwo, an expert in Fibromyalgia & Chronic Fatigue and author at, wrote that she would not be as functional if she did not find out that she was also suffering from MPS after having been diagnosed with fibromyalgia.


  • Mayo Clinic. Fibromyalgia.
  • Is your fibromyalgia primary or secondary? by Adriene Dellwo via Verywell Health

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