Central mechanisms in the maintenance of chronic w

Authors: Josimari M DeSantana Kathleen A Sluka

Publish Date: 2008/10/16

Volume: 12, Issue: 5, Pages: 338-343

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Abstract

Chronic widespread pain CWP conditions such as fibromyalgia and myofascial syndromes are characterized by generalized pain tenderness morning stiffness disturbed sleep and pronounced fatigue However CWP pathophysiology is still unclear A number of hypotheses have been proposed as the underlying pathophysiology of CWP muscular dysfunction/ischemia central sensitization and a deficit in endogenous painmodulating systems This article reviews the current and emerging literature about the pathophysiology and neurobiology of chronic widespread musculoskeletal pain Widespread musculoskeletal pain results in changes in the central nervous system in human subjects and animal models These changes likely reflect alterations in supraspinal modulation of nociception and include increases in excitatory and decreases in inhibitory modulation pathways These alterations in excitation and inhibition likely drive changes observed in the spinal cord to result in central sensitization and the consequent pain and hyperalgesia

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