Research supports a complex neurophysiological ( such as elevated level of Glutamate and drop in the level of GABA in some parts of the nervous system) , neuroendocrine, ( such as decreased the level of IGF-1 or impaired increase level of growth hormone in response to exercise) and immunological ( such as increased level of inflammatory cytokines) causes, with central pain sensitization and amplification.
Associated symptoms include fatigue and sleep problems, subjective cognitive dysfunction, muscle tenderness and stiffness, and environmental sensitivity.
Mainstays of treatment include regular physical exercise, weight loss to reach the ideal BMI;
a healthy antiinflammatory diet ( avoid sugar, trans fat, MSG and Aspartame) ; mind–body, psychotherapeutic, and affective self-awareness activities; treatment of comorbid depression and sleep disorder; judicious trials of conventional pharmaceuticals, including U.S. Food and Drug Administration–approved duloxetine and pregabalin; and many other complementary and alternative medicine modalities. Treatment plans are individualized, flexible, focused on maximizing symptom relief with minimal adverse effects.