Neural and Psychosocial Mechanisms of Pain Sensitivity in Fibromyalgia |
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| Affiliation: | 1. Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals, Faculty of Medicine, Geneva University, Geneva, Switzerland;2. Multidisciplinary Pain Center, Geneva University Hospitals, Faculty of Medicine, Geneva University, Geneva, Switzerland;3. Institute for Social and Preventive Medicine, Geneva University Hospitals, Faculty of Medicine, Geneva University, Geneva, Switzerland;4. Division of Laboratory Medicine, Geneva University Hospitals, Faculty of Medicine, Geneva University, Geneva, Switzerland;1. Department of Psychiatry, Chongqing, China;2. Department of Neurology, Chongqing, China;3. The First Affiliated Hospital of Chongqing Medical University, Chongqing, China;4. Institute of Primary Health Care, University of Bern, Bern, Switzerland;5. Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine and School of Public Health, Kyoto, Japan;6. Department of Psychology, Harvard University, Cambridge, MA, USA;7. Department of Psychiatry, University of Oxford, Oxford, UK;8. Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK;1. Photonics Research Centre, University of Malaya, 50603 Kuala Lumpur, Malaysia;2. Department of Electrical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur Malaysia;3. Department Electrical and Electronic Engineering, National Defense University of Malaysia, Kem Sungai Besi, 57000 Kuala Lumpur, Malaysia;4. Department of Electrical and Computer Engineering, International Islamic University Malaysia, Jalan Gombak, 53100 Kuala Lumpur, Malaysia;5. Fiber Optics and Photonics Division, Central Glass & Ceramic Research Institute, CSIR, Kolkata, India;6. Department of Electronics System Engineering, MJIIT, Universiti Teknologi Malaysia, 54100 Kuala Lumpur, Malaysia |
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| Abstract: | ![]()
Fibromyalgia is a chronic musculoskeletal pain disorder that affects an estimated 5 million adults in the US. The hallmark is burning, searing, tingling, shooting, stabbing, deep aching, or sharp pain. Fibromyalgia is generally considered to be a “central sensitivity syndrome” where central sensitization is regarded as the cause of pain in its own right. Nonetheless, the case continues to be made that all central and spatially distributed peripheral components of fibromyalgia pain would fade if the peripheral generators could be silenced. Although neural mechanisms are clearly important in pain sensitivity, cognitive and social mechanisms also need to be considered. The aim of this review is to examine four mechanisms responsible for heightened pain sensitivity in fibromyalgia: peripheral sensitization, central sensitization, cognitive-emotional sensitization, and interpersonal sensitization. The purpose of framing the review in terms of pain sensitivity in fibromyalgia is to highlight that different mechanisms of sensitization are appropriately regarded as intervening variables when it comes to understanding individual differences in the experience of pain. The paper concludes by considering the implications of the findings of the review for explanations of fibromyalgia pain by nurses working in multidisciplinary teams. The trend appears to be able to explain the cause of fibromyalgia pain in terms of sensitization per se. The recommended alternative is to explain fibromyalgia pain in terms of changes in pain sensitivity and the role of underlying neural and psychosocial mechanisms. |
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