The American Journal of Medicine
Volume 122, Issue 12, Supplement , Pages S22-S30, December 2009

Pathophysiology of Fibromyalgia

  • Laurence A. Bradley, PhD

      Affiliations

    • Corresponding Author InformationRequest for reprints should be addressed to Laurence A. Bradley, PhD, Division of Clinical Immunology and Rheumatology, 177A Shelby Research Building, 1825 University Boulevard, Birmingham, Alabama 35294

Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama USA

Abstract 

This article reviews the biologic, genetic, and environmental factors that may contribute to the pathophysiology of fibromyalgia. As an affective spectrum disorder, fibromyalgia may share these causal factors with a number of related and co-occurring pain conditions, such as irritable bowel syndrome or temporomandibular disorder. There is strong evidence that cardinal pain symptoms of fibromyalgia may be due to alterations in central processing of sensory input, along with aberrations in the endogenous inhibition of pain. Genetic research has shown familial aggregation of fibromyalgia and other related disorders such as major depressive disorder. Exposure to physical or psychosocial stressors, as well as abnormal biologic responses in the autonomic nervous system and neuroendocrine responses, may also contribute to dysfunctional pain processing. As fibromyalgia research continues to progress, it is expected that the pathophysiology of this disorder will be further elucidated, leading to more rational and targeted strategies for the treatment of patients with this condition.

Keywords: Affective spectrum disorders, Autonomic nervous system, Environmental stressors, Fibromyalgia, Genetics, Neuroendocrine system, Pathophysiology

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 Statement of author disclosure: Please see the Author Disclosures section at the end of this article.

 Dr. Bradley has received grant/research support from the National Institutes of Health (NIH), the Agency for Healthcare Research and Quality (AHRQ), and the American Fibromyalgia Syndrome Association (AFSA).

PII: S0002-9343(09)00825-0

doi:10.1016/j.amjmed.2009.09.008

The American Journal of Medicine
Volume 122, Issue 12, Supplement , Pages S22-S30, December 2009