What is the role of negative beliefs in the etiology 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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In patients with chronic pain, the expected degree of tolerance to stimuli or activities that evoke pain or fatigue predicts actual tolerance. Expected danger (damage) predicts avoidance.

Self-assessed inability to work, helplessness, low perceived control over pain, and maladaptive coping all affect pain severity and the overall impact of fibromyalgia. Thus, some patients with fibromyalgia perceive that they are using excessive effort during formal exercise testing of muscle, even though their actual muscle function is electrophysiologically normal.

Similarly, the discordance between self-reported disability versus observed functional disability can be high in some patients with fibromyalgia. In contrast, such discordance is generally low or absent in patients with other rheumatic diseases, such as ankylosing spondylitis and rheumatoid arthritis.

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