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KMID : 0388220090160010001
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Journal of the Korean Rheumatism Association
2009 Volume.16 No. 1 p.1 ~ p.15
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Fibromyalgia Syndrome
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Kim Seong-Ho
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Abstract
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Fibromyalgia syndrome is a major cause of chronic widespread pain and this affects 2.2% of all Koreans. Evidence exists for a genetic contribution to fibromyalgia. Those people who are predisposed to develop fibromyalgia may have this condition "triggered" by a variety of environmental "stressors," including certain types of infections, physical trauma and catastrophic events. Some patients with fibromyalgia have been found to have abnormalities in a number of the body’s "stress response" systems, including the hypothalamus-pituitary-adrenal axis and the autonomic nervous system. The most consistently detected objective abnormalities in fibromyalgia involve the pain-processing systems. Patients with fibromyalgia have displayed quantitative abnormalities in pain perception under experimental conditions. Fibromyalgia may be related to a decrease in the activity of the descending, antinociceptive pathways. In addition to neurobiologic mechanisms, psychologic and behavioral factors also play a role for many patients for the different symptoms they express. Diagnosing and treating these patients is especially challenging due to the limited knowledge of the etiology of this disease and the poor response to conventional pain treatments. Strict adherence to the ACR classification criteria in clinical practice is not required to effectively treat patients with fibromyalgia. The treatments of fibromyalgia should be targeted to the central pain and the neuropsychological symptoms. Current evidence advocates a multifaceted program that emphasizes patient education, medications for improving symptoms and aggressive use of exercise and cognitive-behavioral therapy to restore function.
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KEYWORD
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Fibromyalgia, Chronic pain
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