Where does pain derive from in the pathophysiology of fibromyalgia?

Updated: Nov 14, 2018
  • Author: Chad S Boomershine, MD, PhD, CPI, CPT; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Pain in patients with fibromyalgia derives partly from a generalized decrease in the pain perception threshold, with reduced discrimination of nociceptive sensations from non-nociceptive sensations (eg, touch, warmth, cold), and in the threshold for pain tolerance, resulting in an unwillingness to receive more-intense stimulation. [26]

These phenomena can be demonstrated clinically by pressure algometry (dolorimetry) or in research settings with quantitative sensory testing (QST) using pressure, heat, cold, or electricity as stimuli or with functional magnetic resonance imaging (fMRI) using pain stimuli. [5] Underlying these changes in thresholds is altered processing of nociceptive stimuli in the CNS (central sensitization).


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