Chronic widespread pain (CWP) conditions such as fibromyalgia and myofascial syndromes are characterized by generalized pain, tenderness, morning stiffness, disturbed sleep, and pronounced fatigue. However, CWP pathophysiology is still unclear.
A number of hypotheses have been proposed as the underlying pathophysiology of CWP: muscular dysfunction/ischemia, central sensitization, and a deficit in endogenous pain-modulating systems.
This article reviews the current and emerging literature about the pathophysiology and neurobiology of chronic widespread musculoskeletal pain.
• Widespread musculoskeletal pain results in changes in the central nervous system in human subjects and animal models.
• These changes likely reflect alterations in supraspinal modulation of nociception [modulation of the nervous system’s signal transmission above the spinal cord – i.e., in the brain], and include increases in excitatory and decreases in inhibitory modulation pathways.
• These alterations in excitation and inhibition likely drive changes observed in the spinal cord to result in central sensitization [sensitization of the entire central nervous system], and the consequent pain and hyperalgesia [increased sensitivity to pain].
Source: Current Pain and Headache Reports, Oct 2008;12(5):338-43. PMID: 18765138, by Desantana JM, Sluka KA. Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, USA. [E-mail: email@example.com]