Aryeh M. Abeles, MD; Michael H. Pillinger, MD; Bruce M. Solitar, MD; Micha Abeles, MD
Note: Drs. A.M. Abeles and Pillinger contributed equally to this manuscript.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Aryeh M. Abeles, MD, Department of Rheumatology, New York University Hospital for Joint Diseases, 301 East 17th Street, Suite 410, New York, NY 10003.
Current Author Addresses: Drs. A.M. Abeles and Pillinger: Department of Rheumatology, New York University Hospital for Joint Diseases, 301 East 17th Street, Suite 1410, New York, NY 10003.
Dr. Solitar: Department of Rheumatology, New York University Hospital for Joint Diseases, 333 East 34th Street, Suite 1C, New York, NY 10016.
Dr. M. Abeles: Division of Rheumatology, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030.
Abeles AM, Pillinger MH, Solitar BM, Abeles M. Narrative Review: The Pathophysiology of Fibromyalgia. Ann Intern Med. 2007;146:726-734. doi: 10.7326/0003-4819-146-10-200705150-00006
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Published: Ann Intern Med. 2007;146(10):726-734.
Primary fibromyalgia is a common yet poorly understood syndrome characterized by diffuse chronic pain accompanied by other somatic symptoms, including poor sleep, fatigue, and stiffness, in the absence of disease. Fibromyalgia does not have a distinct cause or pathology. Nevertheless, in the past decade, the study of chronic pain has yielded new insights into the pathophysiology of fibromyalgia and related chronic pain disorders. Accruing evidence shows that patients with fibromyalgia experience pain differently from the general population because of dysfunctional pain processing in the central nervous system. Aberrant pain processing, which can result in chronic pain and associated symptoms, may be the result of several interplaying mechanisms, including central sensitization, blunting of inhibitory pain pathways, alterations in neurotransmitters, and psychiatric comorbid conditions. This review provides an overview of the mechanisms currently thought to be partly responsible for the chronic diffuse pain typical of fibromyalgia.
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Rheumatology, Chronic Fatigue Syndrome/Fibromyalgia.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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