The Science of Fibromyalgia

September 2011
Mayo Clinic Proceedings;Sep2011, Vol. 86 Issue 9, p907
Academic Journal
Fibromyalgia (FM) is a common chronic widespread pain disorder. Our understanding of FM has increased substantially in recent years with extensive research suggesting a neurogenic origin for the most prominent symptom of FM, chronic widespread pain. Neurochemical imbalances in the central nervous system are associated with central amplification of pain perception characterized by allodynla (a heightened sensitivity to stimuli that are not normally painful) and hyperalgesla (an increased response to painful stimuli). Despite this increased awareness and understanding, FM remains undiagnosed in an estimated 75% of people with the disorder. Clinicians could more effectively diagnose and manage FM If they better understood its underlying mechanisms. Fibromyalgia is a disorder of pain processing. Evidence suggests that both the ascending and descending pain pathways operate abnormally, resulting in central amplification of pain signals, analogous to the "volume control setting" being turned up too high. Patients with FM also exhibit changes in the leveis of neurotransmltters that cause augmented central nervous system pain processing; levels of several neurotransmltters that facilitate pain transmission are elevated in the cerebrosplnal fluid and brain, and levels of several neurotransmltters known to Inhibit pain transmission are decreased. Pharmacological agents that act centrally in ascending and/or descending pain processing pathways, such as medications with approved indications for FM, are effective in many patients with FM as well as other conditions involving central pain amplification. Research is ongoing to determine the roie of analogous central nervous system factors in the other cardinal symptoms of FM, such as fatigue, nonrestorative sleep, and cognitive dysfunction.


Related Articles

  • Changes in pain and insulin-like growth factor 1 in fibromyalgia during exercise: the involvement of cerebrospinal inflammatory factors and neuropeptides. Bjersing, Jan L.; Dehlin, Mats; Erlandsson, Malin; Bokarewa, Maria I.; Mannerkorpi, Kaisa // Arthritis Research & Therapy;2012, Vol. 14 Issue 4, p2 

    No abstract available.

  • Fibromyalgia in patients with other rheumatic diseases: prevalence and relationship with disease activity. Haliloglu, Sema; Carlioglu, Ayse; Akdeniz, Derya; Karaaslan, Yasar; Kosar, Ali // Rheumatology International;Sep2014, Vol. 34 Issue 9, p1275 

    Fibromyalgia (FM) is a syndrome characterized by chronic widespread pain and the presence of specific tender points. The prevalence of FM has been estimated at 2-7 % of the general global population. The presence of FM in several rheumatic diseases with a structural pathology has been reported...

  • Does it mean anything to diagnose fibromyalgia (FM) in somebody with chronic widespread pain? Catoggio, Luis // Clinical Rheumatology;Aug2015, Vol. 34 Issue 8, p1323 

    No abstract available.

  • Is it necessary to strictly diagnose fibromyalgia syndrome in patients with chronic widespread pain? On, Arzu; Aykanat, Dilek; Atamaz, Funda; Eyigor, Can; Kocanogullari, Hayriye; Oksel, Fahrettin // Clinical Rheumatology;Aug2015, Vol. 34 Issue 8, p1473 

    The applicability of the American College of Rheumatology (ACR) 1990 and 2010 criteria for the diagnosis of fibromyalgia syndrome (FMS) was determined in 284 patients with chronic widespread pain (CWP) including those with regional and systemic painful disorders. On the basis of initial...

  • Altered profile of chemokines in fibromyalgia patients. García, Juan J; Cidoncha, Antonio; Bote, María E; Hinchado, María D; Ortega, Eduardo // Annals of Clinical Biochemistry;Sep2014, Vol. 51 Issue 5, p576 

    The article focuses on differences in the profile of systemic concentrations of chemokines between fibromyalgia (FM) patients and healthy women. It notes that FM is characterized by chronic pain and its aetiology is not clearly understood. Several studies suggest the involvement of cytokines,...

  • Identification of soluble TREM-2 in the cerebrospinal fluid and its association with multiple sclerosis and CNS inflammation. Laura Piccio; Cecilia Buonsanti; Marina Cella; Ilaria Tassi; Robert E. Schmidt; Chiara Fenoglio; John Rinker; Robert T. Naismith; Paola Panina-Bordignon; Nadia Passini; Daniela Galimberti; Elio Scarpini; Marco Colonna; Anne H. Cross // Brain: A Journal of Neurology;Nov2008, Vol. 131 Issue 11, p3081 

    Triggering receptor expressed on myeloid cells 2 (TREM-2) is a membrane-bound receptor expressed by microglia and macrophages. Engagement of TREM-2 on these cells has been reported to reduce inflammatory responses and, in microglial cells, to promote phagocytosis. TREM-2 function is critical...

  • Suspected Early Lyme Neuroborreliosis in Patients With Erythema Migrans. Ogrinc, Katarina; Lotrič-Furlan, Stanka; Maraspin, Vera; Lusa, Lara; Cerar, Tjaša; Ružič-Sabljič, Eva; Strle, Franc // Clinical Infectious Diseases;Aug2013, Vol. 57 Issue 4, p501 

    Cerebrospinal fluid was analyzed in patients with erythema migrans and symptoms/signs suggesting nervous system involvement. Several epidemiologic, clinical, and microbiologic differences were found between patients with and without pleocytosis. Predictive values of pleocytosis for...

  • Hydranencephaly associated with cerebellar involvement and bilateral microphthalmia and colobomas. Taori, Kishor B.; Sargar, Kiran M.; Disawal, Amit; Chhadi, Shyam; Rathod, Jawahar // Pediatric Radiology;Feb2011, Vol. 41 Issue 2, p270 

    Hydranencephaly is an encephaloclastic central nervous system disorder characterised by severe destruction of the cerebral hemispheres with preservation of posterior fossa structures. We present MRI and neurosonography features of a unique case of hydranencephaly involving cerebellum (in the...

  • Large myelomeningocele repair. Nejat, Farideh; Baradaran, Nima; El Khashab, Mostafa // Indian Journal of Plastic Surgery;Jan2011, p87 

    Background: Wound closure is accomplished in most cases of myelomeningocele (MMC) by undermining of the skin edges surrounding the defect. However, large defects cannot be closed reliably by this simple technique. Due to the technical challenge associated with large MMC, surgeons have devised...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics