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Updated: Jun 29, 2026
08:33
A Randomized, Sham-Controlled Trial of Cranial Electrical Stimulation for Fibromyalgia Pain and Physical Function, Using Brain Imaging Biomarkers
Published on: January 5, 2024
Fibromyalgia syndrome: definition and diagnostic aspects
M Cazzola1, P Sarzi Puttini, S Stisi
1Unit of Rehabilitative Medicine, Hospital of Circolo, Saronno (VA), Italy.
Reumatismo
|July 21, 2009
Summary
Fibromyalgia (FM) remains controversial in rheumatology, with ongoing debate about its diagnostic criteria and classification. Current research suggests classifying FM as a central sensitisation syndrome, linking its symptoms to a common pathogenetic mechanism.
Area of Science:
- Rheumatology
- Neuroscience
- Psychiatry
Background:
- Fibromyalgia (FM) diagnosis is controversial, with debates on its independent entity status.
- The 1990 American College of Rheumatology criteria face criticism for not reflecting clinical reality.
- FM symptoms overlap with other conditions, leading to varied classifications.
Purpose of the Study:
- To review the evolving diagnostic and classification landscape of fibromyalgia.
- To explore the shift in understanding FM from a distinct entity to a manifestation of other systems.
- To propose a more appropriate classification for fibromyalgia.
Main Methods:
- Literature review of diagnostic criteria and classification debates in fibromyalgia.
- Analysis of the evolution of FM conceptualization over time.
- Synthesis of current research on central sensitisation syndromes.
Main Results:
- Fibromyalgia's diagnostic criteria lack universal acceptance and specificity.
- FM has been re-conceptualized as a manifestation of psychoneuroendocrine or stress-related systems.
- Central sensitisation is increasingly recognized as the primary pathogenetic mechanism.
Conclusions:
- Fibromyalgia's classification remains a subject of debate among specialists.
- Current understanding points towards central sensitisation syndromes as the most fitting category for FM.
- This classification better explains the pathogenetic mechanism underlying FM symptoms.
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