The Fibromyalgia Syndrome: Translating Science into Clinical Practice

Abstract

Objectives: The first objective is to present the arguments in favor of considering the biological component of the fibromyalgia syndrome [FMS], a disease of the nociceptive nervous system. The second aim is to present reliable methods for diagnosing such a disease.

Findings: Studies confirm that there is long-standing or permanent pain hypersensitivity in FMS. The main causes of the pain amplification are central and peripheral sensitization of pain transmission neurons and/or pain disinhibition due to a disturbed endogenous pain modulation. The manual palpation method for determining the number of tender points is a measure of pressure-pain thresholds and degree of pain perception. Pain perception is influenced by psychological factors. More objective measures of pain thresholds are available and are presented in the article.

Conclusions: The biological part of FMS reflects a long-standing or permanent change in the function of the nociceptive nervous system, that can be equated with a disease. It is hoped that upgrading FMS from illness to disease will increase the awareness of FMS among health personnel. This will in turn help patients with FMS to get correct diagnosis and treatment.

KEYWORDS:

• Fibromyalgia syndrome
• muscle pain
• central sensitization