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Abstract: Fibromyalgia–from syndrome to disease. overview of pathogenetic mechanisms

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J Rehabil Med. 2003 May;(41 Suppl):89-94.  Henriksson KG.  Department of Neuroscience and Locomotion Section of Medical Rehabilitation, Faculty of Health Sciences, Linkoping University, Sweden. karl-g@telia.com

According to the classification criteria proposed by the American College of Rheumatology, fibromyalgia is a long-standing multifocal pain condition combined with generalised allodynia/hyperalgesia. It is the generalised allodynia/hyperalgesia that distinguishes fibromyalgia from other conditions with chronic musculoskeletal pain.

Central sensitisation of nociceptive neurons in the dorsal horn due to activation of N-methyl-D-aspartic acid receptors and disinhibition of pain due to deficient function of the descending inhibitory system are probable pathogenic factors for allodynia/hyperalgesia.

Furthermore, chronic pain is a chronic emotional and physical stressor. Chronic stress and chronic sleep disturbance are not specific for fibromyalgia but could be the causes of symptoms like fatigue, cognitive difficulties and other stress-related symptoms. They may also cause neuroendocrinological and immunological aberrations.  PMID: 12817664 [PubMed – in process]

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