Fibromyalgia: nosography and therapeutic perspectives.
Fibromyalgia (FM) is an important cause of morbidity and health expenditure. Severe widespread extra-articular chronic pain, along with nonrestorative sleep, dominates the clinical syndrome. The pathogenesis of FM remains unclear. While dysfunction in serotoninergic neurotransmission is believed to play an important role, several neurologic and immuno-endocrine mechanisms may also be relevant. A theory is advanced based on an inherited imbalance in neuro-vegetative systems resulting from increased sympathetic tone because of a metabolic deficiency in the serotoninergic system that, when exposed to a precipitating event, leads to the development of the clinical manifestations of FM. The importance of both nonpharmacological treatments and multimodal medication management is stressed.
Coaccioli
Stefano
S
Department of Internal Medicine and Rheumatology Unit, Perugia University School of Medicine, Terni, Italy. scoaccioli@tin.it
Varrassi
Giustino
G
Sabatini
Chiara
C
Marinangeli
Franco
F
Giuliani
Marco
M
Puxeddu
Adolfo
A
D000700:Analgesics / Q000627:therapeutic use; D003131:Combined Modality Therapy; D015897:Comorbidity; D004298:Dopamine / Q000502:physiology; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D005356:Fibromyalgia / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D006261:Headache / Q000453:epidemiology; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009209:Myofascial Pain Syndromes / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D009490:Neurosecretory Systems / Q000503:physiopathology; D009619:Nociceptors / Q000502:physiology; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D012216:Rheumatic Diseases / Q000145:classification / Q000503:physiopathology; D012701:Serotonin / Q000502:physiology; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D020919:Sleep Disorders, Intrinsic / Q000453:epidemiology / Q000503:physiopathology; D009626:Terminology as Topic
D000700:Analgesics; D004298:Dopamine; D012701:Serotonin; D017367:Selective Serotonin Reuptake Inhibitors