Abstract
Fibromyalgia is a syndrome characterized by chronic and widespread musculoskeletal pain, often accompanied by other symptoms, such as fatigue, intestinal disorders and alterations in sleep and mood. It is estimated that two to eight percent of the world population is affected by fibromyalgia. From a medical point of view, this pathology still presents inexplicable aspects. It is known that fibromyalgia is caused by a central sensitization phenomenon characterized by the dysfunction of neuro-circuits, which involves the perception, transmission and processing of afferent nociceptive stimuli, with the prevalent manifestation of pain at the level of the locomotor system. In recent years, the pathogenesis of fibromyalgia has also been linked to other factors, such as inflammatory, immune, endocrine, genetic and psychosocial factors. A rheumatologist typically makes a diagnosis of fibromyalgia when the patient describes a history of pain spreading in all quadrants of the body for at least three months and when pain is caused by digital pressure in at least 11 out of 18 allogenic points, called tender points. Fibromyalgia does not involve organic damage, and several diagnostic approaches have been developed in recent years, including the analysis of genetic, epigenetic and serological biomarkers. Symptoms often begin after physical or emotional trauma, but in many cases, there appears to be no obvious trigger. Women are more prone to developing the disease than men. Unfortunately, the conventional medical therapies that target this pathology produce limited benefits. They remain largely pharmacological in nature and tend to treat the symptomatic aspects of various disorders reported by the patient. The statistics, however, highlight the fact that 90% of people with fibromyalgia also turn to complementary medicine to manage their symptoms.
Highlights
The results showed a correlation between a decrease in the frequency of spindles during NREM sleep and the level of chronic pain and allodynia, suggesting that this finding could be a biomarker of chronic pain as well as a target for neuromodulator therapy [181]
It is possible to hypothesize that a dysfunctional primitive thalamus causes an alteration in its spindle pacemaker activity and alpha activity, compromising the restorative function of sleep and generating the somatic and psychological symptoms of fibromyalgia, similar to what was suspected by Moldofsky et al In light of the important function of the thalamus in sensory transmission pathways, it can be hypothesized that both sleep disturbances and hyperalgesia/allodynia are the direct result of thalamic alteration, representing independent manifestations of the same pathological process
FM is a complicated syndrome characterized by chronic pain, joint rigidity, fatigue, sleep interruption, cerebral dysfunction and depression
Summary
Fibromyalgia (FM) is a syndrome characterized by chronic musculoskeletal pain. The main symptoms of this disease are muscle stiffness, joint stiffness, insomnia, fatigue, mood disorders, cognitive dysfunction, anxiety, depression, general sensitivity and the inability to carry out normal daily activities [1,2]. The term “fibromyalgia” was later coined by Smythe and Moldofsky following the identification of regions of extreme tenderness known as “pain points” [6] These points are defined as areas of hyperalgesia/allodynia when a pressure of about 4 kg causes pain [7]. According to the ACR, the diagnosis of FM includes two variables: (1) bilateral pain above and below the waist, characterized by centralized pain, and (2) chronic generalized pain that lasts for FM includes two variables:. (1) bilateral pain above and below the waist, characterized at least three months, characterized by pain on palpation in at least of specific body by centralized pain, and (2) chronic generalized pain that lasts for at least three months, sites [10]
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