Fibromyalgia is now considered to be a central nervous system disorder, according to University of Michigan professor of anesthesiology, Daniel Clauw, M.D.
In a scientific session at the American Pain Society Annual Scientific Meeting, Dr. Clauw stated, “Fibromyalgia can be thought of both as a discreet disease and also as a final common pathway of pain centralization and chronification. Most people with this condition have lifelong histories of chronic pain throughout their bodies,” said Dr. Clauw. “The condition can be hard to diagnose if one isn’t familiar with classic symptoms because there isn’t a single cause and no outward signs.”
A press release from the American Pain Society describes that “fibromyalgia pain comes more from the brain and spinal cord than from areas of the body in which someone may experience peripheral pain. The condition is believed to be associated with disturbances in how the brain processes pain and other sensory information.” The society notes that doctors should suspect fibromyalgia in people with musculoskeletal pain “that is not fully explained by injury or inflammation.”
Clauw noted that opioids are often not very effective in treating fibromyalgia because they do not reduce the activity of neurotransmitters in the brain – the premise of a central nervous system problem.
Doctors are now looking to integrate treatments like gabapentinoids, trycyclics and serotonoin reuptake inhibitors, with additional non-drug (and inexpensive) approaches like cognitive behavioral therapy, exercise and stress reduction.
With such an approach, “the majority of patients with fibromyalgia can see improvement in their symptoms and lead normal lives with the right medications and extensive use of non-drug therapies,” Dr. Clauw added.
For a poorly understood and under-diagnosed chronic pain condition, these findings are encouraging and will help clinicians and researchers focus their attention on the underlying problems causing fibromyalgia – the central nervous system.
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