See also: Fibromyalgia: four distinct profiles of underlying pathology; implications for treatment (December 2016) .
The fibromyalgia , ”
characterized by chronic musculoskeletal pain for which no alternative cause can be identified ,” brings together heterogeneous pathologies involving different mechanisms, argue US researchers Kathleen A. Sluka and Daniel J. Clauw in an article synthesis on the neurobiology of fibromyalgia published in the journal Neuroscience (June 2016).
Mark rather shows a deterioration predominant role in the treatment of pain signals by the central nervous system (which includes the brain and spinal cord) which cause sensitization (amplification of the perception of pain), sensory hypersensitivity and that symptoms such as fatigue, cognitive problems ( “fibro fog”) and mood alteration.
Take the test: detection of cerebral sensitivity syndromes (fibromyalgia, chronic fatigue, irritable bowel …) .
Cerebral role is corroborated by functional differences observable by neuroimagingand imbalances in the levels of neurotransmitters that affect pain and sensory transmission.
The different brain changes observed have the potential to enable identification of subtypes of the disease based on different mechanisms.
Cerebral role in fibromyalgia is consistent with the fact that the generally effective drugs against pain caused by tissue damage or inflammation, such as non-steroidal anti-inflammatory drugs (NSAIDs) or local injections are not effective against the pain of fibromyalgia. It would also explain the benefits of exercise , known to alter the transmission of certain neurotransmitters.
Cerebral predominant role does not prevent pain signals from damaged tissue and peripheral nervous system may contribute to the pain perception is amplified by the brain awareness mechanisms.
Among some people with fibromyalgia, cerebral awareness could also be fueled by the pain signals from peripheral system-related diseases such as autoimmune diseases or arthritis , for example. What is suggested by the fact that when the painful peripheral condition is improved, the brain changes appear to be improving too, the researchers said.
Recent studies (2011-2013) began to explore, they relate, alterations of the peripheral nervous system that potentially contribute to the pain of fibromyalgia. ( In some cases, fibromyalgia is rather a sometimes treatable neuropathy , The hypothesis of a small fiber neuropathy is accurate .)
Finally, some studies have also begun to explore the potential role of systemic inflammation.
The authors propose that every person with fibromyalgia lies along a continuum with one end represents the nociceptive pain (due to damage to tissues such as muscle) and the other end, the original pain Central. Between the two are the original neuropathic pain (due to nerve damage).
In an article wanting a white paper on fibromyalgia, published in September 2016 in the Clinical Journal of Pain , one of the authors of this analysis, Daniel J. Clauw, and a dozen colleagues and fibromyalgia are (globally) and other painful disorders along this continuum: