Neurobiology of fibromyalgia and chronic widespread pain
Open accessAbstract
Fibromyalgia is the current term for chronic widespread musculoskeletal pain for which no alternative cause can be identified. The underlying mechanisms, in both human and animal studies, for the continued pain in individuals with fibromyalgia will be explored in this review. There is a substantial amount of support for alterations of central nervous system nociceptive processing in people with fibromyalgia, and that psychological factors such as stress can enhance the pain experience. Emerging evidence has begun exploring other potential mechanisms including a peripheral nervous system component to the generation of pain and the role of systemic inflammation. We will explore the data and neurobiology related to the role of the CNS in nociceptive processing, followed by a short review of studies examining potential peripheral nervous system changes and cytokine involvement. We will not only explore the data from human subjects with fibromyalgia but will relate this to findings from animal models of fibromyalgia. We conclude that fibromyalgia and related disorders are heterogenous conditions with a complicated pathobiology with patients falling along a continuum with one end a purely peripherally driven painful condition and the other end of the continuum is when pain is purely centrally driven.
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There is wide agreement that fibromyalgia syndrome should be considered a central pain sensitization syndrome.
“Although it is not clear how these physiologic alterations are generated, there is a wide agreement that FMS should be considered as a CPSS [9,10,11,32,33,34].”
From Effectiveness of acceptance and commitment therapy in central pain sensitization syndromes: A systematic review (2021) · cites this paper as [34]
The Summary (page unavailable) says there is strong evidence for a central nervous system component in the majority of people with fibromyalgia. It also describes fibromyalgia as heterogeneous, with some people having stronger peripheral than central contributions. This supports a central-sensitization account, but not the unqualified classification of all FMS as a central pain sensitization syndrome or the claim of wide agreement on that classification. (LLM, conf=0.84)
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- Authors
- Sluka, K. A., & Clauw, D. J.
- Affiliations
- University of Iowa (US)
- University of Michigan (US)
- Corresponding author
- Sluka, Kathleen A.
- Venue
- Neuroscience
- Publisher
- Elsevier BV
- Published
- 2016-12
- Volume
- 338
- Pages
- 114-129
- ISSN
- 0306-4522 (ISSN-L)
- PMC
- PMC5083139
- OpenAlex
- W2415752306
- Cited by
- 671
- References
- 194
- Citations by year
- 2026: 49 · 2025: 68 · 2024: 71 · 2023: 70 · 2022: 96 · 2021: 78 · 2020: 89 · 2019: 64 · 2018: 42 · 2017: 39 · 2016: 3 · 2015: 1
- FWCI
- 7.04
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R01DA038261)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (UM1AR063381, R01AR061371)
- 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, nociceptive processing, central nervous system, psychological stress, peripheral nervous system, systemic inflammation, cytokines
- MeSH terms
- Animals, Brain, Fibromyalgia, Humans, Spinal Cord, Chronic Pain
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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