ABSTRACT
INTRODUCTION Fibromyalgia (FM) is an extreme manifestation of chronic widespread pain (CWP) with a prevalence of 2% in the general population (1). Clinically, individuals with FM present with a variety of symptoms including widespread pain, fatigue, tenderness, sleep disturbance, decrements in physical functioning, and disruptions in psychological functioning (e.g., memory problems, concentration difficulties, diminished mental clarity, mood disturbances, and lack of well-being) (2-5). FM occurs more frequently in females and the comorbid overlap of FM with related functional disorders [e.g., temporomandibular disorder (TMD), irritable bowel syndrome (IBS), chronic fatigue syndrome (CFS)] is extremely high (6,7). Triggering of FM requires a genetic predisposition coupled with environmental stressors (8-13). The maintenance of FM symptoms over time appears related to centrally mediated amplification of the processes integrating sensory, cognitive, and affective information, dysfunction in endogenous noxious inhibitory systems, sleep disturbance, and dysautonomia (14-18). Thus, it is likely that there are multiple dysregulated pathways by which a given individual can develop the clinical picture qualifying for the diagnosis of FM.
