Cited by 86Fibromyalgia and Chronic Fatigue Syndrome ResearchPain Mechanisms and TreatmentsPain Management and Treatment

Fibromyalgia

Janice E. Sumpton, Dwight E. Moulin·2014·Handbook of Clinical Neurology

Abstract

Fibromyalgia is a chronic pain condition present in 2-4% of the population. Fibromyalgia consists of widespread pain with similarities to neuropathic pain in clinical findings, pathophysiology, and neuropharmacology. Pain is the predominant symptom and allodynia and hyperalgesia are common signs. Extreme fatigue, impaired cognition and nonrestorative sleep difficulties coexist in addition to other somatic symptoms. Research including neuroimaging investigations shows abnormalities in neurotransmitters and an abnormal response to pain. Altered pain processing peripherally and centrally contribute to central sensitization and a dampened effect of the diffuse noxious inhibitory control (DNIC). Successful management incorporates education of the patient in self-management skills, cognitive behavioral therapy (CBT), exercise, and drug therapy. Tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors (SNRIs) (duloxetine and milnacipran), α2-δ ligands (gabapentin and pregabalin) are effective in reducing pain by≥30%. Some success has been shown with dopamine agonists (pramipexole), tramadol, other opioids and cannabinoids (nabilone). Further evidence-based trials using complementary treatments are needed. Fibromyalgia is complex and requires a multidisciplinary approach to treatment. Patient self-management is key.

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Crossref · 10.1016/b978-0-7020-4086-3.00033-3

Cites

124 of 124 references verified0 citation errors · 0 not checkable

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Cites

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Research works printed but not linked: 5

  1. Bradley, 1996, Abnormal brain regional cerebral blood flow (rCBF) and cerebrospinal fluid (CSF) levels of substance P (SP) in patients and non-patients with fibromyalgia (FM), Arthritis Rheum, 39, S212
  2. Goldenberg, 2008, Multidisciplinary modalities in the treatment of fibromyalgia, J Clin Psychiatry, 69, 30
  3. Starz, 2008, Fibromyalgia – it’s not all in my head, Pain Pract, 18, 62
  4. Welin, 1995, Elevated substance P levels are contrasted by a decrease in metenkephalin-arg-phe levels in CSF from fibromyalgia patients, J Musculoskelet Pain, 3, 4
  5. Zijlstra, 2002, Venlafaxine in fibromyalgia: results of a randomized, placebo-controlled, double-blind trial [abstract], Arthritis Rheum, 46, S105

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Authors
Sumpton, J. E., & Moulin, D. E.
Affiliations
  • London Health Sciences Centre (CA)
  • Western University (CA)
Corresponding author
Janice E. Sumpton
Venue
Handbook of Clinical Neurology
Publisher
Elsevier
Published
2014
Volume
119
Pages
513-527
ISSN
0072-9752 (ISSN-L)
OpenAlex
W109879893
Cited by
86
References
124
Citations by year
2026: 2 · 2025: 6 · 2024: 8 · 2023: 5 · 2022: 14 · 2021: 16 · 2020: 7 · 2019: 13 · 2018: 3 · 2017: 3 · 2016: 4 · 2015: 4 · 2014: 1
FWCI
13.52
Type
book chapter
Language
en
Open access
closed
Locations
  • Handbook of clinical neurology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords
fibromyalgia, chronic widespread pain, central sensitization, diffuse noxious inhibitory control, allodynia, hyperalgesia, fatigue, sleep disorders, cognitive impairment, neurotransmitter abnormalities, tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, gabapentin, pregabalin, dopamine agonists, tramadol, opioids, cannabinoids, nabilone, cognitive behavioral therapy, physical activity, patient self-management, multidisciplinary treatment
MeSH terms
Fibromyalgia, Humans, History, 20th Century, History, 21st Century

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