Trauma and fibromyalgia--black and white? Or 50 shades of grey?

Fibromyalgia (FM) is relatively common, with prevalence estimates between 2.0% and 3.5%1​,2,3​. Its prevalence increases with age, up to around age 60 to 70 years; FM is roughly 5 times more common in women than in men4, and is one of the most common reasons for referral to a rheumatologist5​. The etiology and pathophysiology of FM are not well determined, and while there are several extant theories — including muscle dysfunction or misuse, central sensitization, sleep disorders, and altered stress axis function — there is little consistent evidence to support, or refute, any of these.