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Mechanisms of Fibromyalgia Pain

Published online by Cambridge University Press:  07 November 2014

Roland Staud
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Extract

Chronic musculoskeletal pain is highly prevalent in the United States and includes inflammatory and non-inflammatory syndromes, such as low back pain (reported by 59 million Americans in the past 3 months), neck pain (reported by 30.1 million Americans in the past 3 months), clinical osteoarthritis (reported by 27 million Americans in the past 3 months), and fibromyalgia (FM). FM affects between 2% to 4% of the US population or 12 million people. Inflammatory pain conditions commonly reported by patients include rheumatoid arthritis (2.5 million) and gout (3 million), among others. This article will focus primarily on FM, which is a chronic pain condition that predominately affects women.

The current diagnostic criteria for FM include chronic widespread pain for at least 3 months and the presence of widespread mechanical tenderness. A patient with suspected FM must report pain in all four body quadrants and have at least 11 of 18 tender points for a positive diagnosis to be made. Tender points are areas of the body where pressure is applied until pain threshold is achieved. In addition to pain and tenderness, FM patients very frequently describe widespread stiffness and fatigue, disrupted or poor sleep, dyscognition, and mild soft tissue swelling. Patients often also report symptoms of anxiety and depression.

Type
Research Article
Information
CNS Spectrums , Volume 14 , Issue S16: Fibromyalgia Facts: Foundations for Assessment, Care, and Treatment Strategies , August 2009 , pp. 4 - 5
Copyright
Copyright © Cambridge University Press 2009

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References

1.Lawrence, RC, Felson, DT, Helmick, CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008;58(1):26–35.CrossRefGoogle ScholarPubMed
2.Buskila, D, Cohen, H. Comorbidity of fibromyalgia and psychiatric disorders. Curr Pain Headache Rep. 2007;11(5):333–338.CrossRefGoogle ScholarPubMed
3.Wolfe, F, Smythe, HA, Yunus, MB, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990;33(2):160–172.CrossRefGoogle ScholarPubMed
4.Aaron, LA, Arguelles, LM, Ashton, S, et al. Health and functional status of twins with chronic regional and widespread pain. J Rheumatol. 2002;29(11):2426–2434.Google ScholarPubMed
5.Sperber, AD, Atzmon, Y, Neumann, L, et al. Fibromyalgia in the irritable bowel syndrome: studies of prevaence and clinical implications. Am J Gastroenterol. 1999;94(12):3541–3546.CrossRefGoogle ScholarPubMed
6.Whitehead, WE, Palsson, O, Jones, KR. Systematic review of the comorbidity of irritable bowel syndrome with other disorders: what are the causes and implications? Gastroenterology. 2002;122(4):1140–1156.CrossRefGoogle ScholarPubMed
7.Aaron, LA, Burke, MM, Buchwald, D. Overlapping conditions among patients with chronic fatigue syndrome, fibromyalgia, and temporomandibular disorder. Arch intern Med. 2000;160(2):221–227.CrossRefGoogle ScholarPubMed
8.Weir, PT, Harlan, GA, Nkoy, FL, et al. The incidence of fibromyalgia and its associated comorbidities a population-based retrospective cohort study based on International Classification of Diseases, 9th Revision codes. J Clin Rheumatol. 2006;12(3):124–128.CrossRefGoogle ScholarPubMed
9.Staud, R. Chronic widespread pain and fibromyalgia: two sides of the same coin? Curr Rheumatol Rep. 2009;11(6):433–436.CrossRefGoogle ScholarPubMed
10.White, KP, Nielson, WR, Harth, M, Ostbye, T, Speechley, M. Chronic widespread musculoskeletal pain with or without fibromyalgia: Psychological distress in a representative community adult sample. J Rheumatol. 2002;29(3):588–594.Google ScholarPubMed
11.Staud, R. Abnormal pain modulation in patients with spatially distributed chronic pain: fibromyalgia. Rheum Dis Clin North Am. 2009;35(2):263–274.CrossRefGoogle ScholarPubMed
12.Staud, R. Evidence of involvement of central neural mechanisms in generating fibromyalgia pain. Curr Rheumatol Rep. 2002;4(4):299–305.CrossRefGoogle ScholarPubMed
13.Staud, R, Vierck, CJ, Cannon, RL, Mauderli, AP, Price, DD. Abnormal sensitization and temporal summation of second pain (wind-up) in patients with fibromyalgia syndrome. Pain. 2001;91(1-2):165–175.CrossRefGoogle ScholarPubMed
14.Staud, R, Spaeth, M. Psychophysical and neurochemical abnormalities of pain processing in fibromyalgia. CNS Spectr. 2008;13(3suppl 5):12–17.CrossRefGoogle ScholarPubMed
15.Staud, R, Nagel, S, Robinson, ME, Price, DD. Enhanced central pain processing of fibromyalgia patients is maintained by muscle afferent input: a randomized, double-blind, placebo-controlled study. Pain. 2009;145(1-2):96–104.CrossRefGoogle ScholarPubMed
16.Liu, Z, Welin, M, Bragee, B, Nyberg, F. A high-recovery extraction procedure for quantitative analysis of substance P and opioid peptides in human cerebrospinal fluid. Peptides. 2000;21(6):853–860.CrossRefGoogle ScholarPubMed
17.Russell, IJ, Vaeroy, H, Javors, M, Nyberg, F. Cerebrospinal fluid biogenic amine metabolites in fibromyalgia/fibrositis syndrome and rheumatoid arthritis. Arthritis Rheum. 1992;35(5):550–556.CrossRefGoogle ScholarPubMed
18.Staud, R, Craggs, JG, Robinson, ME, Perlstein, WM, Price, DD. Brain activity related to temporal summation of C-fiber evoked pain. Pain. 2007;129(1-2):130–142.CrossRefGoogle ScholarPubMed
19.Harris, RE, Sundgren, PC, Craig, AD, et al. Elevated insular glutamate in fibromyalgia is associated with experimental pain. Arthritis Rheum. 2009;60(10):3146–3152.CrossRefGoogle ScholarPubMed
20.Kato, K, Sullivan, PF, Evengård, B, Pedersen, NL. Importance of genetic influences on chronic widespread pain. Arthritis Rheum. 2006;54(5):1682–1686.CrossRefGoogle ScholarPubMed
21.Arnold, LM, Hudson, JI, Hess, EV, et al. Family study of fibromyalgia. Arthritis Rheum. 2004;50(3):944–952.CrossRefGoogle ScholarPubMed