Cited by 350Fibromyalgia and Chronic Fatigue Syndrome ResearchPain Mechanisms and TreatmentsMyofascial pain diagnosis and treatment

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Fibromyalgia: An Overview

Clauw, Daniel J.·2009·The American Journal of Medicine

DOI 10.1016/j.amjmed.2009.09.006

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Abstract

Fibromyalgia is the diagnosis given to individuals with chronic widespread musculoskeletal pain for which no alternative cause, such as tissue inflammation or damage, can be identified. Fibromyalgia is now believed to be, at least in part, a disorder of central pain processing that produces heightened responses to painful stimuli (hyperalgesia) and painful responses to nonpainful stimuli (allodynia). Aberrations in central pain processing may also be partly responsible for symptoms experienced in several chronic pain disorders that coaggregate with fibromyalgia, which is itself a product of genetic and environmental factors. Thus, aberrational central pain processing is implicated in irritable bowel syndrome, temporomandibular disorder, chronic low back pain, and certain other chronic pain disorders. Fibromyalgia and related disorders appear to reflect deficiencies in serotonergic and noradrenergic, but not opioidergic, transmission in the central nervous system. The heightened state of pain transmission may also be owing to increases in pronociceptive neurotransmitters such as glutamate and substance P. In some cases, psychological and behavioral factors are also in play. Although the overlapping symptomatology between fibromyalgia and related disorders may present diagnostic challenges, proper examination and observation can help clinicians make an accurate diagnosis. In recent years, the vastly improved understanding of the mechanism underlying fibromyalgia and the related spectrum of diseases has fostered rapid advances in the therapy of these chronic pain disorders by both pharmacologic and nonpharmacologic interventions.

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Authors: Clauw, D. J.
Affiliations: University of Michigan (US)
Corresponding author: Clauw, Daniel J.
ORCID: Clauw, Daniel J.
Venue: The American Journal of Medicine
Publisher: Elsevier BV
Published: 2009-12
Volume: 122
Issue: 12
Pages: S3-S13
ISSN: 0002-9343 (ISSN-L)
DOI: 10.1016/j.amjmed.2009.09.006
OpenAlex: W2024269125
Cited by: 350
References: 147
Citations by year: 2026: 13 · 2025: 14 · 2024: 13 · 2023: 12 · 2022: 22 · 2021: 29 · 2020: 17 · 2019: 15 · 2018: 13 · 2017: 17 · 2016: 16 · 2015: 18 · 2014: 38 · 2013: 34 · 2012: 39
FWCI: 3.16
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: The American Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Myofascial pain diagnosis and treatment
Keywords: fibromyalgia, central sensitization, hyperalgesia, allodynia, chronic widespread pain, irritable bowel syndrome, temporomandibular disorders, chronic low back pain, serotonergic neurotransmission, noradrenergic neurotransmission, glutamate, substance P, psychosocial factors, fibromyalgia diagnosis, fibromyalgia treatment
MeSH terms: Analgesics, Antidepressive Agents, Brain, Fibromyalgia, Humans, Magnetic Resonance Imaging, Neurosecretory Systems, Pain, Sleep Wake Disorders, Stress, Physiological, Tomography, Emission-Computed, Single-Photon

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