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Related Experiment Videos

Pain in fibromyalgia.

J B Winfield1

  • 1Division of Rheumatology and Immunology, University of North Carolina, Chapel Hill, USA. johnvwinfield@med.unc.edu

Rheumatic Diseases Clinics of North America
|March 20, 1999
PubMed
Summary
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Chronic stress, particularly from childhood adversity, can lead to fibromyalgia by altering stress response systems. This research suggests fibromyalgia exists on a spectrum of distress, not as a distinct disease.

Area of Science:

  • Neuroscience
  • Psychology
  • Pain Management

Background:

  • Modern life presents chronic stressors unlike acute ancestral threats.
  • Neuroendocrine and pain regulation systems, evolved for acute stress, may be maladaptive in chronic stress.
  • Childhood adversity can predispose individuals to fibromyalgia through long-lasting psychological and neurophysiological effects.

Purpose of the Study:

  • To explore the link between chronic stress, psychological vulnerability, and fibromyalgia.
  • To investigate the neurobiological underpinnings of pain and fatigue in fibromyalgia patients.
  • To position fibromyalgia within a continuum of distress and pain.

Main Methods:

  • Review of psychological and neurobiological evidence.
  • Analysis of stress response axes (e.g., HPA axis) and pain regulatory mechanisms.

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  • Consideration of patient vulnerability factors and coping strategies.

    • Main Results:

    • Chronic stress may blunt the hypothalamic-pituitary-adrenal (HPA) axis and other stress response systems.
    • Alterations in pain regulatory mechanisms are associated with fibromyalgia symptoms.
    • Fibromyalgia patients often exhibit maladaptive coping, low self-efficacy, and negative mood due to stress.

    Conclusions:

    • Fibromyalgia may result from chronic stress-related blunting of stress response axes and altered pain mechanisms.
    • Individuals meeting fibromyalgia criteria represent the most severely affected on a spectrum of distress and pain.
    • Fibromyalgia is viewed as a manifestation of distress rather than a discrete disease entity.