Is Fibromyalgia a Central Pain State?

SUMMARY

Objective: To review the literature concerning pain mechanisms in fibromyalgia [FMS].

Findings and Conclusions: Thirteen investigations using different methods, comprising 250 patients with FMS, confirm a biological dysfunction of the nociceptive system, especially in the central nervous system in the majority of patients with FMS. The hyperexcitability in the nociceptive nervous system may have different causes in the individual patient. Localized long-standing muscle pain, chronic stress, genetic factors, and hormonal changes may all play a role. Pain generators in the muscle may not be specific for FMS but may be of importance for initiating and maintaining pain and allodynia/hyperalgesia.

KEYWORDS:

• Fibromyalgia
• pain mechanisms
• muscular pain
• central sensitization