The fibromyalgia (FM) syndrome: musculoskeletal pathophysiology

Fibromyalgia (FM) is a chronic pain disorder that afflicts

predominantly middle-aged women with cardinal symptoms of

diffuse musculoskeletal pain, defined tender points, deprived

sleep, and fatigue. The etiology and pathological mechanisms

are poorly understood, and treatment approaches are largely

ineffective. The clinical features of the syndrome are

presented, and the relevance of muscle dysfunction in the

etiopathogenesis of the disorder is explored. The evidence for

involvement of muscle pathophysiology as a primary mechanism

mediating the onset of symptoms is not compelling.

Musculoskeletal dysfunction can be considered secondary to

central abnormalities of pain modulation and altered sleep

physiology precipitated by emotional stress in genetically

predisposed individuals. Contemporary evidence favors

treatment strategies that emphasize pain control, sleep

enhancement, and a program of conditioning.

Geel SE

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