Abstract
The pathogenesis of fibromyalgia (FM) pain is currently unknown, but abnormal responses to chronic stress may play a critical role for many FM abnormalities, including increased temporal summation of pain, fatigue, and negative affect. Central pain mechanisms appear to be relevant for clinical FM pain, because up to 50% of the variance can be explained by central sensitization and affective distress. In addition, tonic peripheral nociceptive input may play an important role for the initiation and maintenance of FM pain. Although only infrequently cured, FM, like many other chronic pain syndromes, is a treatable illness. Effective disease management programs include tricyclic antidepressants, aerobic exercise, and cognitive behavioral therapies. Future treatment strategies, however, will benefit from interventions that focus on abnormal FM pain mechanisms, including peripheral and central sensitization as well as negative affect.
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