Fibromyalgia (FM) is a syndrome that comes under the category of musculoskeletal disorders causing different symptoms in the body. Fibromyalgia is the second most prevalent disorder that affects the muscles and the bones, and commonly patients may be more sensitive to pain.

The characteristic features are:

• fatigue

• joint pain

• generalized muscle pain in the whole body

Fibromyalgia is an idiopathic disease with unknown causes. However, the most common and wide-known is brain stimulation for pain. The brain and spinal cord both stimulate the nerve signals to produce pain and lethargy in the bones, joints, and muscles throughout the body. The most important reason for this abnormal signaling can be the irregular release of certain chemicals as neurotransmitters from the brain. These chemicals are responsible for the firing and relaxation of neuronal signals. 

Other factors of FM may include:

• Infectious disorders: An illness that includes events of inflammations and infections that are capable of triggering the fibromyalgia onset in the body.

• Genetic predisposition: Fibromyalgia can be a genetic disorder that can run through multiple generations. Several genetic mutations and modifications are the responsible factors for fibromyalgia.

• Emotional or physically triggering events: Sometimes, FM can be the result of emotional or physical triggers which cause the body to behave differently.  Prolonged depression and stress can be the contributing factors in fibromyalgia incidence and prevalence. 

The most common risk factors include:

• Family: Having history/genetic predisposition – genetics has a strong and direct link with fibromyalgia prevalence in the next generations.

• Age and gender: Women in their earlier years of life are more prone to develop Fibromyalgia in comparison to the male gender.

• Other disorders: Other autoimmune disorders such as RA (Rheumatoid Arthritis), lupus erythematosus, and osteoarthritis affect the natural immune system of the body and make it pro-inflammatory. These events can trigger the incidence of Fibromyalgia, leading to its characteristic symptoms and features. 

The primary and most common symptoms include:

• Fatigue: Individuals who have Fibromyalgia are often tired with a poor sleep routine. The patients always report a dull ache or constant pain in their bodies. In these patients, quality of sleep disrupts due to pain, sleep apnea, and restless legs syndrome.

• Perceptual difficulties: The most common effect of Fibromyalgia is altered perception or cognitive difficulties. These patients tend to suffer from the condition of fibro fog, which shows a deficit in the attention or focus span of the individual. 

Other co-morbidities may coexist with Fibromyalgia as:

• Headaches (different types) and migraine

• Chronic fatigue syndrome

• Irritable bowel syndrome

• Painful bladder syndrome or interstitial cystitis

• Depression and anxiety

• Postural tachycardia syndrome

• Insomnia and difficulty in sleeping at night

• Temporomandibular joint disorders

Fibromyalgia can interfere with your ability to respond or work in your home, working environment, and social groups. The severe symptoms can cause frustration and depression leading to negative and suicidal thoughts.

Treatment for FM consists of certain medications as:

• Anti-seizure drugs: Medications used to treat epilepsy as Gabapentin and Pregabalin, which are significant for decreasing the onset of epilepsy-like symptoms of fibromyalgia.

• Antidepressant drugs: Duloxetine and milnacipran can help in easing the pain symptoms of the disease, which have a strong association with fibromyalgia.

• Opioid drugs: OTC drugs as ibuprofen, acetaminophen, and naproxen sodium can help in relieving the pain symptoms. However, these drugs aren’t the ultimate treatment or cure for the disorder. These drugs can cause a worsening of the situation, leading to more dependence on these drugs for proper functioning.

Stem Cells are the building blocks of the human body, which have a natural tendency to regenerate our body cells and tissues. The innovative medical field now allows the regeneration of cells through an effective and implementable treatment protocol for chronic fatigue and fibromyalgia. Stem Cell Therapy (SCT) for Fibromyalgia is a unique approach because it involves a series of steps and stages to cure the problem.

For Fibromyalgia, Stem Cell Therapy involves injecting CD34+ enriched MSC (Mesenchymal Stem Cells) inside the patient's body for the targeted regeneration therapy. A similar therapy regimen is also available for other diseases such as idiopathic pulmonary fibrosis, diabetes type-2, and cerebral palsy.

Our body releases a specific SDF-1 protein in stress, guiding the cellular movements surrounding the cells to initiate healing. This function is termed a homing function, which aids in guiding the newly entered cells to reach their targeted area for regeneration and repair activities. Allogenic or autologous stem cells are mostly derived from the placenta, cord blood, bone marrow, peripheral blood, and circulatory blood. 

According to the clinical literature, Exosomes combined with MSCs help in autoimmune diseases by regulating the inflammatory cytokines, microenvironment, and immune cells. These processes have a potent relation with both adaptive and innate immune cells. In these cells, macrophages, Treg cells, Th17, immunoregulatory miRNAs, and CD4+Th1 are the most crucial ones. 

Exosomes-combined-MSCs help in the regulation of T-Cell subsets in cases of autoimmune diseases. Moreover, the MSCs-Exosomes also aid in reducing the levels and concentration of pro-inflammatory Th17 and TH1 cytokines as IL-17AF, IL-12p70, and IL-6. However, the same MSCs-Exosomes help in increasing the concentration of anti-inflammatory Treg. 

Therefore, MSCs-Exosomes increase the concentration of Treg cells and the related products without changing the concentration index of the lymphocytes to maintain immunoregulation in the body. Similar effects of these cells are seen in the cases of RA (rheumatoid arthritis) and GVHD (graft-versus-host disease). MSCs-Exosomes help improve the GVHD by suppressing the differentiation of populations of the naïve T-cells. Macrophages constitute a crucial and major portion of the innate immunity of the human body, which can be regulated through the administration of MSCs-Exosomes. According to the different microenvironments, Mo (naïve macrophages) can be polarized into anti-inflammatory (M2) or pro-inflammatory (M1) to play different roles in different conditions. Along with the autoimmune conditions, this combination therapy can also help facilitate metabolic hemostasis to attenuate obesity and adipose inflammation. Moreover, MSCs-Exosomes can also promote the M1-M2 macrophage conversion to reduce the pro-inflammatory factors or effects of the macrophage M1.

Generally, Stem Cell Therapy is a safe procedure, but no medical treatment is harmless.

The most expected or common risk factors of SCT can be:

• Nausea and vomiting

• Fever

• Painful injection area /site

• Lethargy and fatigue

• Allergic reactions

Allergic reactions are preventable through pre-injection history and care. Fatigue, fever, and pain are managed through the appropriate drugs along with the treatment. In case of nausea and vomiting, you can take some rest and take a revitalizing, fresh liquid.

All the treatment options for Fibromyalgia are significant for treating the symptoms, but Stem Cell Therapy can be a holistic approach to eradicate the root cause of the problem. With the invention of Stem Cells Replacement Therapy, hopes and prognosis of the disease treatment have been raised. It has the potential to be more effective than previous methods and also carries less risk.