Fibromyalgia - Pathogenesis and causes

Although the pathogenesis of fibromyalgia remains unknown, recently known anomalies argue that fibromyalgia is no longer considered just a subjective painful condition. Biochemical changes observed in brain, low levels of serotonin, increased 4-fold of nerve growth factor and high levels of substance P leads to hypersensitivity to pain throughout the body and suggests that fibromyalgia may be a condition of central sensitization or abnormal processing painful stimuli.
Pain in patients with fibromyalgia derives in part from a generalized loss of pain perception, reflecting a quality discrimination against a nonnociceptiva nociceptive (touch, heat, cold) and depending on the tolerance to pain, reflecting the stronger rejection of painful stimuli. These phenomena can be demonstrated clinically using quantitative sensory testing dolometrie or pressure, heat, cold or electricity as a stimulus.Underlying these changes be altered processing of nociceptive stimuli in the brain.There is fear associated with pain which may be trivial or profound.Neurophysiological experience painful sensations derived dintrun-perception complex interactions involving the simultaneous processing of nociceptive stimuli to the spinal cord to multiple brain regions.
SerotoninThe anomaly of the best known and studied is associated with decreased serotonin fibromyalgia. Many studies have linked serotonin, a neurotransmitter with sleep, pain perception, headaches and emotional changes. Low levels of serotonin in the brain is the cause of low CSF trptofan.
Substance PSubstance P, a neuropeptide in the CSF, is a neurotransmitter that is released when axons are stimulated. Increased levels of substance P increase the sensitivity of nerve.
Dysfunction of the hypothalamic-pituitary-adrenal axisIt is believed that aspects of neuroendocrine dysfunction in fibromyalgia are mediated by the spindle. HPA axis is a critical component of adaptation to stress. In a normal functional system, the release of CRH stimulates the pituitary gland to release ACTH nterioara == ABN. ACTH stimulates the adrenal cortex to produce glucocorticoids, potent mediators of adaptation response to stress.
Causes and Risk Factors
Development of fibromyalgia involve elements of vulnerability: female sex, genetics, abuse or other traumatic experiences in childhood when the brain is still developing and persistent stress or distress. Predictors of progression of acute pain chronic pain are high anxiety and distress, pain relief and slow history of trauma.Women.Mediated effects of sex are important for fibromyalgia and pain in general. Central pain modulation systems in women are influenced by hormones, hormone alternating phase-breeders.Sleep.All fibromyalgia patients sleep poorly.Trauma and tissue distrucita.Trauma is a trigger of fibromyalgia.Depression and anxiety.Psychiatric comorbidities are common in patients with fibromyalgia, including bipolar disorders, major depression, generalized anxiety, obsessive-compulsive disorders, panic, social phobias, eating disorders and substance use hallucinogens.Other predisposing factors for fibromyalgia include:-Negative psychosocial experiences, childhood abuzulrileLack of family supportLack of satisfaction at workThe fear of pain, needles, injections, surgery-Emotional instability, hypervigilance.