Narrative review: The pathophysiology of Fibromyalgia

Journal: Annals of Internal Medicine. 2007 May 15;146(10):726-34. Read the full text of this article at

Authors and affiliation: Abeles AM, Pillinger MH, Solitar BM, Abeles M. New York University School of Medicine, New York University Hospital for Joint Diseases, and New York Harbor Healthcare System, New York, New York, USA.

PMID: 17502633

Primary Fibromyalgia is a common yet poorly understood syndrome characterized by diffuse chronic pain accompanied by other somatic symptoms, including poor sleep, fatigue, and stiffness, in the absence of disease.

Fibromyalgia does not have a distinct cause or pathology. Nevertheless, in the past decade, the study of chronic pain has yielded new insights into the pathophysiology of Fibromyalgia and related chronic pain disorders. Accruing evidence shows that patients with fibromyalgia experience pain differently from the general population because of dysfunctional pain processing in the central nervous system.

Aberrant pain processing, which can result in chronic pain and associated symptoms, may be the result of several interplaying mechanisms, including central sensitization, blunting of inhibitory pain pathways, alterations in neurotransmitters, and psychiatric comorbid conditions.

This review provides an overview of the mechanisms currently thought to be partly responsible for the chronic diffuse pain typical of Fibromyalgia.

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