What is the pathophysiology of fibromyalgia?

Updated: Apr 23, 2020
  • Author: Chad S Boomershine, MD, PhD, CPI, CPT; Chief Editor: Herbert S Diamond, MD  more...
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Fibromyalgia is currently understood to be a disorder of central pain processing or a syndrome of central sensitivity.  Research has provided evidence for altered functional connectivity and chemistry in the pain-processing system of the brain. [17]

Clauw describes the syndrome as a diffuse problem of sensory “volume control” such that patients have a lower threshold of pain and of other stimuli, such as heat, noise, and strong odors. Clauw also suggests that patients may have hypersensitivity because of neurobiologic changes that affect the perception of pain or because of expectancy or hypervigilance, which may be related to psychological factors. [18]

Although the pathogenesis of fibromyalgia is not completely understood, research shows biochemical, metabolic, and immunoregulatory abnormalities. These substantiate the proposal that fibromyalgia can no longer be considered a subjective pain condition.

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