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Pathophysiology in fibromyalgia syndrome 

Pathophysiology in fibromyalgia syndrome
Chapter:
Pathophysiology in fibromyalgia syndrome
Author(s):

Ernest Choy

DOI:
10.1093/med/9780198723233.003.0003
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date: 31 March 2020

Pain processing is complex and involves nociception, transmission, modulation, and perception. Pain signal is transmitted from peripheral nerve fibres, via the dorsal horn of the spinal cord, to the somatosensory cortex. Pain processing in the brain includes stress and emotive responses, as well as pain modulation centres, which suppress pain via descending inhibitory pathways. Physiological pain is important in protection against harm, whilst maladaptive pain is caused by dysfunction of the nociceptive system. One of the typical features of maladaptive pain is central sensitization, which can be defined as an increased response to stimulation that is mediated by amplification of signalling in the central nervous system. Central sensitization is a consistent feature in patients with fibromyalgia syndrome. Pain can now be examined objectively with modern neuroimaging techniques such as functional magnetic resonance imaging scan. Indeed, functional magnetic resonance imaging scan has demonstrated that patients with fibromyalgia syndrome are not malingerers and the pain is ‘real’.

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