Good Article About Source of FM Pain

Fibromyal­gia Pain: Do We Know the Source?

Roland Staud
Abstract

Pur­pose of review: Fibromyal­gia Syn­drome (FMS) is a chron­ic pain con­di­tion of unknown ori­gin. Mul­ti­ple abnor­mal­i­ties have been described, includ­ing periph­er­al tis­sue and cen­tral ner­vous sys­tem changes. The rela­tion of these mech­a­nisms, how­ev­er, is like­ly bidi­rec­tion­al. FMS pain clear­ly depends on periph­er­al noci­cep­tive input as well as abnor­mal cen­tral pain pro­cess­ing. This review will focus on the role of periph­er­al noci­cep­tive input for pain in FMS.

Recent find­ings: There is strong evi­dence for abnor­mal cen­tral pain pro­cess­ing in FMS. Sen­si­tized spinal cord neu­rons in the dor­sal horn are respon­si­ble for aug­ment­ed pain pro­cess­ing of noci­cep­tive sig­nals from the periph­ery. In addi­tion, glial acti­va­tion, pos­si­bly by cytokines and exci­ta­to­ry amino acids may play a role in the ini­ti­a­tion and per­pet­u­a­tion of this sen­si­tized state.

Sum­ma­ry: Noci­cep­tive input clear­ly plays an impor­tant role in FMS. Acute or repet­i­tive tis­sue injury has been asso­ci­at­ed with FMS pain. Cytokines relat­ed to such injuries may be respon­si­ble for long-term acti­va­tion of spinal cord glia and dor­sal horn neu­rons, thus result­ing in cen­tral sen­si­ti­za­tion. A bet­ter under­stand­ing of these impor­tant neu­ro-immune inter­ac­tions may pro­vide rel­e­vant insights into future effec­tive therapies.

(Med­scape does require reg­is­tra­tion, but it’s free—and a great resource.)