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