Abstract
Introduction and purpose: Fibromyalgia is a chronic condition affecting almost 2% of the general population, mostly women. The main symptoms are chronic diffuse musculoskeletal pain or stiffness, tiredness, nonrestorative sleep, anxiety, depression and cognitive dysfunction. The etiology of fibromyalgia remains unclear and has been the subject of debate and scientific investigation. The aim of this article was to collect and analyse current and new information on the etiology of fibromyalgia and present the most popular hypotheses.Brief description of the state of knowledge: Pathogenesis of fibromyalgia is multifactorial. Genetic factors, in addition to environmental factors, such as psychical stress and various types of infection, are considered to be the triggers of the disease. Central sensitization became a commonly accepted hypothesis of the fibromyalgia’s pathogenesis. However, the newest finding of small fiber neuropathy in patients with fibromyalgia supports another hypothesis, in which the disease is presented as stress-related dysautonomia with neuropathic pain features.Conclusions: Understanding the pathogenesis of fibromyalgia is essential to provide the best care to the patients with fibromyalgia. Although there are multiple evidence for central sensitization hypothesis, new findings continue to emerge and question commonly accepted paradigm. Despite numerous findings on etiology of fibromyalgia, more studies are needed.
Highlights
Introduction and purposeFibromyalgia (FM) is a disease, characterized by chronic widespread pain with a low pain threshold
Introduction and purposeFibromyalgia is a chronic condition affecting almost 2% of the general population, mostly women
Throughout the last years, etiology of fibromyalgia seemed to be well explained by central sensitization theory
Summary
Fibromyalgia (FM) is a disease, characterized by chronic widespread pain with a low pain threshold. The main symptoms of fibromyalgia are chronic diffuse musculoskeletal pain or stiffness, typically accompanied by tiredness, sleep disturbances, anxiety, depression and memory problems [1,2]. There are no objective tests for fibromyalgia [3,4]. If the effect is insufficient, individualized treatment should be applied, such as cognitive behavioral therapy, pharmacotherapy (for pain, sleep problems, severe depression or anxiety) or multimodal rehabilitation programs [5]. There are number of reasons why this data may be understated, such as potential physicians’ poor knowledge about FM, absence of objective tests to confirm the diagnosis, stigmatization of patients with FM, under diagnosis of comorbid FM in patients with some other primary disease blurring the classical clinical presentation or diagnosing as psychiatric disease [7,8]. The prevalence of fibromyalgia emphasizes the importance of the disease. The aim of this review was to collect and analyze current and new information on the etiology of fibromyalgia and to present the most popular hypotheses
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