Since this situation occurs almost anywhere and involves many locales at once, multiple symptoms evolve. Therefore, all laboratory tests and X-rays are normal. I assume Fibromyalgia is caused by one or more defective genes since I have treated as many as three generations of some families with this diagnosis. It is unusual not to obtain a history of similar complaints or of osteoarthritis in older family members. So common is this information as to make me suspect that osteoarthritis is often the natural sequel of long-standing Fibromyalgia.
Some mutations seem more rapidly symptomatic than others and cause symptoms in early life.
Other, less- impacting, genetic alterations only slowly effect patients at very variable ages and levels of severity. At first, long gaps between attacks are usual causing physician and patient to miss the connection. Eventually, symptoms merely cycle from bad to worse and allow no more good days. All we have seen, so-grouped, have been Fibromyalgic. My approach to this illness is controversial.