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Q:  I would like to know if fibromyalgia runs in families. In my family, we have three people diagnosed with it and two others have symptoms. We are all women and it seems to start around 30 to 35 for most of us. I am concerned it may not be fibromyalgia. Could something else be going on?

A: Fibromyalgia can run in families. In one study, the risk of having fibromyalgia was 8.5 times higher among family members of a person with the condition than among family members of someone with rheumatoid arthritis.

Fibromyalgia is a poorly understood disorder that causes widespread pain and soreness to pressure (tender points) in many areas of the body. Low energy and poor quality sleep are also common. Its cause is unknown. However, one theory suggests that fibromyalgia is caused by disordered pain regulation in genetically prone individuals. 

Although research to date is not definitive, there is some evidence that fibromyalgia is more common among people who carry certain gene variations. These genes are involved in controlling chemical messengers, such as serotonin and dopamine, that may be important in pain perception.

Fibromyalgia is common, affecting up to 5 percent of the population, and it's much more common in women than men. Symptoms usually begin between the ages of 35 and 50. It’s possible that multiple family members could have fibromyalgia just by chance, even if it’s not genetically determined.

Fibromyalgia is a diagnosis of exclusion. That means it's important for your doctors to make sure there is no other explanation for the symptoms. There are a number of conditions that can mimic features of fibromyalgia, including rheumatoid arthritis, thyroid disease, and sleep apnea.

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Robert H. Shmerling, M.D., is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center.