Stress and psychophysiological dysregulation in patients with fibromyalgia syndrome.
Fibromyalgia syndrome (FMS) is a prevalent musculoskeletal pain disorder characterized by diffuse pain and associated psychophysiological symptoms. Despite extensive research in the past 3 decades, the etiology and pathophysiology of FMS and effective treatment approaches are yet to be delineated. Recently, it has been suggested that FMS may be related to hypofunctional stress systems, particularly in the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis. Studies have demonstrated that patients with FMS exhibit lowered sympathoadrenal reactivity to stress. These findings seem to be consistent with the large volume of research indicating the inverse relationship between pain sensitivity and sympathetic reactivity. In this paper, we discuss the role of stress in the pain experience in general, stress in patients with FMS, and review the studies evaluating the ANS and HPA functions in response to various stressors.
Division of Pain Research and Management, Department of Anesthesiology, University of Utah School of Medicine, 615 Arapeen Drive, Suite 200, Salt Lake City, Utah 84108, USA. akiko.okifuji@hsc.utah.edu
Akiko
A
Okifuji
Dennis C
DC
Turk
D005356:Fibromyalgia / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D010146:Pain; D011602:Psychophysiologic Disorders / Q000209:etiology*; D012720:Severity of Illness Index; D013315:Stress, Psychological