RESEARCH - Evidence overwhelming that fibromyalgia pain is real

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Evidence " Overwhelming " That Fibromyalgia Pain Is Real

NEW YORK (Reuters Health) Dec 26 - Based on a review of published studies,

there is now " overwhelming " evidence that fibromyalgia is real, report two

researchers from the University of Michigan Medical School in the journal

Current Pain and Headache Reports.

" It is time for us to move past the rhetoric about whether these conditions

are real, and take these patients seriously as we endeavor to learn more

about the causes and most effective treatments for these disorders, " write

Drs. E. and J. Clauw.

Fibromyalgia is characterized by a lower pain threshold and is associated

with genetic factors, they note. It affects 2%-4% of the population, often

causing debilitating pain, and is often misdiagnosed as arthritis or deemed

psychogenic.

The scientific literature, however, does not support this, Drs. and

Clauw point out. On the contrary, the data suggest that fibromyalgia and a

number of overlapping pain syndromes are characterized in part by " augmented

central nervous system processing of pain, as evidenced by hyperalgesia

and/or allodynia on examination. "

" This phenomenon can occur in association with certain psychological factors

(e.g. catastrophizing), but psychological factors are not in any way

required for an individual to develop or maintain this augmented central

pain state. "

Functional magnetic resonance imaging and single photon emission computed

tomography studies have revealed differences between patients with and

without fibromyalgia in central brain structures.

In addition, researchers recently reported evidence suggesting that a

genetic polymorphism of the COMT (catechol-O-methyl transferase) gene may

explain variations in pain sensitivity. Mutations in COMT have also been

linked to the development of temporomandibular joint pain.

Additional support for the validity of fibromyalgia, Drs. and Clauw

note, comes from the beneficial effects on fibromyalgia pain achieved with

drugs such as tricyclics and anticonvulsants that are known to increase

anti-nociceptive influences.

Current Pain Headache Rep 2006;10:403-407

http://www.medscape.com/viewarticle/549896

Not an MD