Pathogenesis of fibromyalgia
- Don L Goldenberg, MD
Don L Goldenberg, MD
- Section Editor — Pain Disorders in Rheumatology
- Emeritus Professor of Medicine, Tufts University School of Medicine
- Affiliate Assistant, Rheumatology Division, Oregon Health Science University
- Affiliate Instructor, School of Nursing Oregon Health Sciences University
Fibromyalgia (FM) is a chronic pain disorder with unknown etiology and unclear pathophysiology [1,2].
There is no evidence that a single event “causes” FM. Rather, many physical and/or emotional stressors may trigger or aggravate symptoms. These have included certain infections, such as a viral illness or Lyme disease, as well as emotional or physical trauma [1-3].
A detailed description of the clinical manifestations of FM and an approach to the diagnosis of FM in adults and children are presented separately. (See "Clinical manifestations and diagnosis of fibromyalgia in adults" and "Fibromyalgia in children and adolescents: Clinical manifestations and diagnosis".)
FM is only one of many causes of widespread pain. A discussion of the differential diagnosis of FM and the broad differential diagnosis is presented separately. (See "Differential diagnosis of fibromyalgia".)
Fibromyalgia (FM) is considered to be a disorder of pain regulation, classified often under the term central sensitization [1,2,4] (see 'Altered pain processing' below). FM shares several features with other common pain disorders that are considered to be more central rather than peripheral pain conditions, such as migraine, tension headaches, temporomandibular joint disorder, and irritable bowel syndrome; these features include common genetic and central nervous system pain processing characteristics. More limited studies have suggested there might also be a role for peripheral neuropathic mechanisms or focal tissue changes in some patients. (See 'Peripheral pain mechanisms' below.).
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