Abnormal Pain Processing in Patients with FM

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Study: Abnormal Pain Processing in Patients with Fibromyalgia Syndrome

Journal: J of Chronic Fatigue Syndrome, Vol. 12, No. 1, pp. 71-77, 2004

Author: Staud MD, Associate Professor of Medicine, University of

Florida College of Medicine, Gainesville, FL.

Abstract:

Fibromyalgia syndrome (FMS) is characterized by widespread pain, fatigue,

sleep abnormalities, and distress. Because FMS lacks consistent evidence for

tissue abnormalities, recent investigations have focused on central nervous

system mechanisms of pain.

Abnormal temporal summation of second pain (AWindup) and central

sensitization (CS) have recently been described in FMS patients. Windup

(WU) and central sensitization, which rely on central pain mechanisms, occur

after prolonged C-nociceptor input and depend on activation of nociceptor

specific neurons as well as wide dynamic range neurons in the dorsal horn of

the spinal cord.

The important role of WU is also supported by its ability to predict the

clinical pain intensity of FMS patients. Furthermore, brain-imaging techniques

that can detect neuronal activation following nociceptive stimuli have

provided additional evidence for abnormal central pain mechanisms in FMS.

Most importantly, brain images have corroborated the augmented reported

pain experience of FMS patients during experimental pain stimuli. These

findings may have important implications for future research as well as the

treatment of FMS pain.