Do you know the difference between a cause and a risk factor? What about a causal factor? I've seen multiple comments lately that make me think it's a gray area for a lot of people.
For example, in posts about risk factors for fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS), I frequently get reader comments saying, "That can't be right because I don't have X," or "I've never done X," or "X doesn't run in my family." Many people seem to think a risk factor is the same as a cause.
Let's look at the definitions:
- Cause: something that plays an essential role in the onset of a disease.
- Causal Factor: one of several factors linked to the onset of a disease.
- Risk Factor: something that increases the likelihood of developing a disease.
When doctors label something a "cause," they're describing a direct path between the cause and the illness. Example: HIV causes AIDS -- everyone with AIDS is HIV positive. A "risk factor" is a statistical relationship. Having frequent unprotected sex is a risk factor for AIDS. Not everyone who has frequent unprotected will end up with AIDS, and not everyone with AIDS has had frequent unprotected sex. Statistically, there's a relationship between unsafe sex and AIDS, and therefore it's a risk factor.
More and more, the medical community is talking about "causal factors," because few diseases have only one cause. We'll probably never be able to talk about a single, straight-forward cause of FMS or ME/CFS, but we are learning more about possible causal factors.
A cause or causal factors must be present for the illness to be present. Something caused the illness or it wouldn't be there. At the same time, someone with no known risk factors can wind up with the disease. We've all heard about incredibly healthy people who have a heart attack while out jogging -- they may have had no risk factors for heart disease, and yet something caused it. Meanwhile, the guy sitting on his couch eating cheeseburgers is fine, even though he has multiple risk factors.
In FMS and ME/CFS, researchers say risk factors can include things like smoking, obesity, early menopause, and childhood abuse. That doesn't mean we all fit those criteria or that they caused our illness, it means that they're statistically more likely in us than in other people. Some factors, like obesity and early menopause, may simply point to a common underlying dysfunction. Is smoking indicative of high anxiety levels or does it cause physiological changes? Does abuse figure in because of psychological stress that leads to changes in hormones and brain chemistry, or is it because abused children are more likely to have chronic pain?
Each of us probably has a different combination of risk factors. For example, I had sleep disorders, chronic pain and early menopause but not smoking, child abuse or severe menstrual cycles. When researchers talk about risk factors, they're not saying all of us have that in common or that it's the reason we're sick, they're looking something that statistically observable but with (so far) no clear causal relationship. Risk factors are important for identifying possible causes, and for figuring out who's at risk so we focus on early detection and treatment, or possibly prevention.
It's the same with causal factors -- it appears that a host of causal factors can lead to FMS or ME/CFS, and that could well be why we're all so different when it comes to symptoms and treatment. Most researchers thing we all have a genetic predisposition. To trigger the illness, it might take 1 causal factor (i.e., viral infection or reactivation, physical trauma) or it could take several (sleep disorder, chronic back pain, prolonged psychological stress, hormonal fluctuation.)
I hope this clarifies the difference for you, so it won't be confusing (or infuriating) when you see a list of risk factors or causal factors that doesn't fit your situation.
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- Possible Causes of Fibromyalgia
- Possible Causes of Chronic Fatigue Syndrome
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Hi! I just wanted to let you know that I’ve enjoyed reading *all* of your posts for the past several years, I’m just randomly pickin today to tell you.
I am. 29f stricken with cfs after a bout of mono when I was away at college at 20. Never in my wildest dreams thought that that simple mono diagnosis would leave me in bed for basically the past 9 years. Great news to report though, which I hope inspires all wok cfs: after a 3 month wait (which I hear is incredibly short for these matters) I was awarded SSDI. My hope is not so much for myself, but that this idicates some trend with SSSI beginning to really see that cfs is a truly devasajting disase and one in which you absolutely can’t work while having. It was sad though, at the same time, to have the government agree that I was how sick I had been saying for years I was.
Oh I’m Judy blabbering now. Point of my post was to thank you knidly for all of your hardworking in getting these blogs together to share with us all.
Sorry for ALL the typos! Am still learning to type on this phone!
I really don’t think it matters what we call it – cause, causal factor or risk factor.
I believe it really boils down to our genetics. Any number of stressors to our body can send us into full blown fibro. We’re all different and therefore our breaking point is also.
Having said that, it is probably more our reaction to stress that makes the difference between us and so-called normal people. Time to reprogram our brains.
I know obesity and lack of exercise are often related to FM and I see a lot of Dr.s wanting us to exercise and lose weight but I sometimes wonder if they have the cart before the horse. I did not exercise but was very physically active (gardening and such) before I came down with this condition but am not able to do that sort of thing now and have also gained weight since. All of my problems are not caused by the fibro itself I know. I have bad osteoarthritis in my back (probably thanks to all that gardening) and a fall a few years back made a mess out of my knees but it seems almost like all this started with the fibro diagnosis and has gotten worse at an exponential rate since then.
& to throw one more term into the mix, there’s correlation…..something that may be associated with something else, but may or may not actually have anything to do with causing it
ie: A & B are correlated because they often occur together, but: A could cause B; B could cause A; or they may not actually effect each other at all
The author seems to believe that a set of causal factors leads to CFS. This may be true, but the research is still out on this one.
To Nitalynn, please don’t believe whoever told you “obesity and lack of exercise are often related to FM”
I was fit and active before I was diagnosed with this dreadful disease! I am now unable to exercise or be active thus the weight gain.