Fibromyalgia syndrome: Unraveling the mystery
Fibromyalgia (FM) is a common chronic widespread pain disorder. Understanding this disease has increased substantially in recent years with extensive research. Neurochemical imbalances in the central nervous system are associated with central amplification of pain perception characterized by allodynia and hyperalgesia. Despite this increased awareness and understanding, FM remains undiagnosed in an estimated 75% of people with the disorder. Fibromyalgia is a disorder of pain processing. Evidence suggests that both the ascending and descending pain pathways operate abnormally, resulting in central amplification of pain signals, analogous to the “volume control setting” being turned up too high. Patients with FM also exhibit changes in the levels of neurotransmitters that cause augmented central nervous system pain processing; levels of several neurotransmitters that facilitate pain transmission are elevated in the cerebrospinal fluid and brain, and levels of several neurotransmitters known to inhibit pain transmission are decreased. Pharmacological agents that act centrally in ascending and or descending pain processing pathways, such as medications with approved indications for FM, are effective in many patients of FM as well as other conditions involving central pain amplification.
Keywords: Pain signal, Allodynia, Hyperalgesia, Pain Processing, Pain Pathways, Central Amplification of Pain, Neurotransmitters, Central Pain Sensitization, Serotonin, Epinephrine, Substance P, Duloxetine, Milnacipram, Empowerment