Fibromyalgia – an old-new paradigm for chronic pain

Fibromyalgia is a common chronic disorder:

  • It affects 2 -4% of the population
  • Has a female preponderance
  • Is characterized by multifocal pain
  • Often accompanied by fatigue, memory problems and sleep disturbance
  • Pathophysiology is still uncertain
  • Mainly defined as an afferent processing disorder which is primarily central in nature

Evolution of thinking on Fibromyalgia (old thinking)

  • Initially thought of as a discrete illness
  • Consisted of focal areas of tenderness
  • Pathophysiology poorly understood and initially thought to be psychological in nature

Evolution in thinking of Fibromyalgia (new thinking)

  • Now thought of as initial common pathway (Pain Centralization)
  • Part of a much larger continuum
  • Not just involving pain
  • Pathophysiology fairly well understood and is a CNS process that is independent from classical psychological processes
Laura Coutts