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Central sensitization: A biopsychosocial explanation for chronic widespread pain in patients with Fibromyalgia and Chronic Fatigue Syndrome

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By M Meeus and J Nijs • www.ProHealth.com • November 29, 2006


Journal: Clinical Rheumatology. 2006 Nov 18; [E-publication ahead of print] Authors and affiliation: Meeus M, Nijs J. Department of Human Physiology, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel (VUB), Brussel, Belgium. PMID: 17115100

In addition to the debilitating fatigue, the majority of patients with Chronic Fatigue Syndrome (CFS) experience chronic widespread pain. These pain complaints show the greatest overlap between CFS and Fibromyalgia (FM). Although the literature provides evidence for central sensitization as cause for the musculoskeletal pain in FM, in CFS this evidence is currently lacking, despite the observed similarities in both diseases.

The knowledge concerning the physiological mechanism of central sensitization, the pathophysiology and the pain processing in FM, and the knowledge of the pathophysiology of CFS lead to the hypothesis that central sensitization is also responsible for the sustaining pain complaints in CFS. This hypothesis is based on the hyperalgesia and allodynia reported in CFS, on the elevated concentrations of nitric oxide presented in the blood of CFS patients, on the typical personality styles seen in CFS, and on the brain abnormalities shown on brain images.

To examine the present hypothesis more research is required. Further investigations could use similar protocols to those already used in studies of pain in FM like, for example, studies of temporal summation, spatial summation, the role of psychosocial aspects in chronic pain, etc.




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