Current Pain and Headache Reports

, Volume 10, Issue 6, pp 403–407 | Cite as

How do we know that the pain in fibromyalgia is "real"?

Article

Abstract

Fibromyalgia is a common idiopathic pain condition often resulting in increased morbidity and disability in patients. The lack of peripheral abnormalities in this disease has led clinicians and researchers alike to question if this syndrome represents a valid entity. Recent genetic findings suggest that specific gene mutations may predispose individuals to develop fibromyalgia. In addition, neurobiological studies indicate that fibromyalgia patients have abnormalities within central brain structures that normally encode pain sensations in healthy pain-free controls. Future studies that focus on central neurobiological and/or genetic influences in fibromyalgia may bring insight into mechanisms of this problematic disease and ultimately result in improved treatments.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Wolfe F: 50 years of antirheumatic therapy: the prognosis of rheumatoid arthritis. J Rheumatol 1990, 22(Suppl):24–32.Google Scholar
  2. 2.
    Hadler NM: "Fibromyalgia" and the medicalization of misery. J Rheumatol 2003, 30:1668–1670.PubMedGoogle Scholar
  3. 3.
    Crofford LJ, Clauw DJ: Fibromyalgia: where are we a decade after the American College of Rheumatology classi fication criteria were developed? Arthritis Rheum 2002, 46:1136–1138.PubMedCrossRefGoogle Scholar
  4. 4.
    Bendtsen L: Central sensitization in tension-type headache-possible pathophysiological mechanisms. Cephalalgia 2000, 20:486–508.PubMedCrossRefGoogle Scholar
  5. 5.
    Chang PF, Arendt-Nielsen L, Graven-Nielsen T, Chen AC: Psychophysical and EEG responses to repeated experimental muscle pain in humans: pain intensity encodes EEG activity. Brain Res Bull 2003, 59:533–543.PubMedCrossRefGoogle Scholar
  6. 6.
    Bragdon EE, Light KC, Costello NL, et al.: Group differences in pain modulation: pain-free women compared to pain-free men and to women with TMD. Pain 2002, 96:227–237.PubMedCrossRefGoogle Scholar
  7. 7.
    Wolfe F, Smythe HA, Yunus MB, et al.: The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990, 33:160–172.PubMedCrossRefGoogle Scholar
  8. 8.
    Petzke F, Khine A, Williams D, et al.: Dolorimetry performed at 3 paired tender points highly predicts overall tenderness. J Rheumatol 2001, 28:2568–2569.PubMedGoogle Scholar
  9. 9.
    Granges G, Littlejohn G: Pressure pain threshold in pain-free subjects, in patients with chronic regional pain syndromes, and in patients with fibromyalgia syndrome. Arthritis Rheum 1993, 36:642–646.PubMedCrossRefGoogle Scholar
  10. 10.
    Wolfe F, Ross K, Anderson J, Russell IJ: Aspects of fibromyalgia in the general population: sex, pain threshold, and fibromyalgia symptoms. J Rheumatol 1995, 22:151–156.PubMedGoogle Scholar
  11. 11.
    Petzke F, Gracely RH, Khine A, Clauw DJ: Pain sensitivity in patients with fibromyalgia (FM): expectancy effects on pain measurements. Arthritis Rheum 1999, 42:S342.Google Scholar
  12. 12.
    Mense S, Hoheisel U, Reinert A: The possible role of substance P in eliciting and modulating deep somatic pain. Prog Brain Res 1996, 110:125–135.PubMedCrossRefGoogle Scholar
  13. 13.
    Teders SJ, Blanchard EB, Andrasik F, et al.: Relaxation training for tension headache: comparative efficacy and cost-effectiveness of a minimal therapist contact versus a therapist-delivered procedure. Behav Ther 1984, 15:59–70.CrossRefGoogle Scholar
  14. 14.
    Wilder-Smith OH, Tassonyi E, Arendt-Nielsen L: Preoperative back pain is associated with diverse manifestations of central neuroplasticity. Pain 2002, 97:189–194.PubMedCrossRefGoogle Scholar
  15. 15.
    Kashima K, Rahman OI, Sakoda S, Shiba R: Increased pain sensitivity of the upper extremities of TMD patients with myalgia to experimentally-evoked noxious stimulation: possibility of worsened endogenous opioid systems. Cranio 1999, 17:241–246.PubMedGoogle Scholar
  16. 16.
    Maixner W, Fillingim R, Booker D, Sigurdsson A: Sensitivity of patients with painful temporomandibular disorders to experimentally evoked pain. Pain 1995, 63:341–351.PubMedCrossRefGoogle Scholar
  17. 17.
    Leffler AS, Hansson P, Kosek E: Somatosensory perception in a remote pain-free area and function of diffuse noxious inhibitory controls (DNIC) in patients suffering from long-term trapezius myalgia. Eur J Pain 2002, 6:149–159.PubMedCrossRefGoogle Scholar
  18. 18.
    Whitehead WE, Holtkotter B, Enck P, et al.: Tolerance for rectosigmoid distention in irritable bowel syndrome. Gastroenterology 1990, 98:1187–1192.PubMedGoogle Scholar
  19. 19.
    Gibson SJ, Littlejohn GO, Gorman MM, et al.: Altered heat pain thresholds and cerebral event-related potentials following painful CO2 laser stimulation in subjects with fibromyalgia syndrome. Pain 1994, 58:185–193.PubMedCrossRefGoogle Scholar
  20. 20.
    Kosek E, Ekholm J, Hansson P: Increased pressure pain sensibility in fibromyalgia patients is located deep to the skin but not restricted to muscle tissue [published erratum appears in Pain 1996, 64:605]. Pain 1995, 63:335–339.PubMedCrossRefGoogle Scholar
  21. 21.
    Giesecke J, Reed BD, Haefner HK, et al.: Quantitative sensory testing in vulvodynia patients and increased peripheral pressure pain sensitivity. Obstet Gynecol 2004, 104:126–133.PubMedGoogle Scholar
  22. 22.
    Giesecke T, Gracely RH, Grant MA, et al.: Evidence of augmented central pain processing in idiopathic chronic low back pain. Arthritis Rheum 2004, 50:613–623.PubMedCrossRefGoogle Scholar
  23. 23.
    Diatchenko L, Slade GD, Nackley AG, et al.: Genetic basis for individual variations in pain perception and the development of a chronic pain condition. Hum Mol Genet 2005, 14:135–143. This is the first report of a genetic polymorphism that predicts the development of a chronic pain condition. Similar findings may result in studies of fibromyalgia.PubMedCrossRefGoogle Scholar
  24. 24.
    Zubieta JK, Heitzeg MM, Smith YR, et al.: COMT val158met genotype affects mu-opioid neurotransmitter responses to a pain stressor. Science 2003, 299:1240–1243.PubMedCrossRefGoogle Scholar
  25. 25.
    Buskila D, Neumann L: Genetics of fibromyalgia. Curr Pain Headache Rep 2005, 9:313–315.PubMedCrossRefGoogle Scholar
  26. 26.
    Arnold LM, Hudson JI, Hess EV, et al.: Family study of fibromyalgia. Arthritis Rheum 2004, 50:944–952. This article suggests that fibromyalgia has a strong genetic component.PubMedCrossRefGoogle Scholar
  27. 27.
    Mogil JS, McCarson KE: Finding pain genes: bottomup and top-down approaches. J Pain 2000, 1(Suppl 3):66–80.PubMedCrossRefGoogle Scholar
  28. 28.
    Mountz JM, Bradley LA, Modell JG, et al.: Fibromyalgia in women. Abnormalities of regional cerebral blood flow in the thalamus and the caudate nucleus are associated with low pain threshold levels. Arthritis Rheum 1995, 38:926–938.PubMedCrossRefGoogle Scholar
  29. 29.
    Kwiatek R, Barnden L, Tedman R, et al.: Regional cerebral blood flow in fibromyalgia: single-photon-emission computed tomography evidence of reduction in the pontine tegmentum and thalami. Arthritis Rheum 2000, 43:2823–2833.PubMedCrossRefGoogle Scholar
  30. 30.
    Guedj E, Taieb D, Cammilleri S, et al.: (99m)Tc-ECD brain perfusion SPECT in hyperalgesic fibromyalgia. Eur J Nucl Med Mol Imaging 2006, In press.Google Scholar
  31. 31.
    Adiguzel O, Kaptanoglu E, Turgut B, Nacitarhan V: The possible effect of clinical recovery on regional cerebral blood flow deficits in fibromyalgia: a prospective study with semiquantitative SPECT. South Med J 2004, 97:651–655.PubMedCrossRefGoogle Scholar
  32. 32.
    Gracely RH, Petzke F, Wolf JM, Clauw DJ: Functional magnetic resonance imaging evidence of augmented pain processing in fibromyalgia. Arthritis Rheum 2002, 46:1333–1343.PubMedCrossRefGoogle Scholar
  33. 33.
    Cook DB, Lange G, Ciccone DS, et al.: Functional imaging of pain in patients with primary fibromyalgia. J Rheumatol 2004, 31:364–378.PubMedGoogle Scholar
  34. 34.
    Giesecke T, Gracely RH, Williams DA, et al.: The relationship between depression, clinical pain, and experimental pain in a chronic pain cohort. Arthritis Rheum 2005, 52:1577–1584.PubMedCrossRefGoogle Scholar
  35. 35.
    Gracely RH, Geisser ME, Giesecke T, et al.: Pain catastrophizing and neural responses to pain among persons with fibromyalgia. Brain 2004, 127:835–843.PubMedCrossRefGoogle Scholar
  36. 36.
    Julien N, Goffaux P, Arsenault P, Marchand S: Widespread pain in fibromyalgia is related to a deficit of endogenous pain inhibition. Pain 2005, 114:295–302.PubMedCrossRefGoogle Scholar
  37. 37.
    Staud R, Vierck CJ, Cannon RL, et al.: Abnormal sensitization and temporal summation of second pain (wind-up) in patients with fibromyalgia syndrome. Pain 2001, 91:165–175.PubMedCrossRefGoogle Scholar
  38. 38.
    Russell IJ, Orr MD, Littman B, et al.: Elevated cerebrospinal fluid levels of substance P in patients with the fibromyalgia syndrome. Arthritis Rheum 1994, 37:1593–1601.PubMedCrossRefGoogle Scholar
  39. 39.
    Sarchielli P, Alberti A, Floridi A, Gallai V: Levels of nerve growth factor in cerebrospinal fluid of chronic daily headache patients. Neurology 2001, 57:132–134.PubMedGoogle Scholar
  40. 40.
    Alpar EK, Onuoha G, Killampalli VV, Waters R: Management of chronic pain in whiplash injury. J Bone Joint Surg 2002, 84:807–811.CrossRefGoogle Scholar
  41. 41.
    Russell IJ, Vaeroy H, Javors M, Nyberg F: Cerebrospinal fluid biogenic amine metabolites in fibromyalgia/fibrositis syndrome and rheumatoid arthritis. Arthritis Rheum 1992, 35:550–556.PubMedCrossRefGoogle Scholar
  42. 42.
    Yunus MB, Dailey JW, Aldag JC, et al.: Plasma tryptophan and other amino acids in primary fibromyalgia: a controlled study. J Rheumatol 1992, 19:90–94.PubMedGoogle Scholar
  43. 43.
    Arnold LM, Keck PEJ, Welge JA: Antidepressant treatment of fibromyalgia. A meta-analysis and review. Psychosomatics 2000, 41:104–113.PubMedCrossRefGoogle Scholar
  44. 44.
    Goldenberg DL, Burckhardt C, Crofford L: Management of fibromyalgia syndrome. JAMA 2004, 292:2388–2395.PubMedCrossRefGoogle Scholar

Copyright information

© Current Science Inc 2006

Authors and Affiliations

  1. 1.Department of Medicine, Division of RheumatologyUniversity of Michigan Medical CenterAnn ArborUSA

Personalised recommendations