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KMID : 0948920100090020072
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Clinical Pain
2010 Volume.9 No. 2 p.72 ~ p.76
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Update in Fibromyalgia
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Choi Eun-Seok
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Abstract
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Fibromyalgia, a poorly-understood chronic pain syndrome, is marked by widespread musculoskeletal pain and multiple symptoms such as sleep disturbance, fatigue, cognitive dysfunction, and depressive episodes, all in the absence of otherwise apparent organic disease. While the etiology of fibromyalgia is still not unclear, 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 study has shown familial aggregation of fibromyalgia and other related disorders like irritable bowel syndrome and temporomandibular disorder. In some cases, psychological and behavioral factors are also in play. The presentation of fibromyalgia is heterogenous, and the treatment approach should be individualized for each patient. The management of fibromyalgia includes the identification and treatment of all pain sources that may be present in addition to fibromyalgia, such as co-morbid peripheral pain generators (e.g., osteoarthritis or neuropathic pain) or visceral pain (e.g., irritable bowel syndrome). It is also important to address that the treatment should strive to improve the patient’s function and global health status. In most cases, the management of fibromyalgia involves both pharmacologic and nonpharmacologic treatment. The recent advancement in the knowledge of concept, pathophysiology and management of fibromyalgia deserves to attention of the physicians who are interested in the management of the patients with chronic musculoskeletal pain.
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KEYWORD
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Fibromyalgia, Chronic pain syndrome, Pathophysiology, Management
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