Fibromyalgia in particular are memes (a meme is an idea, behavior or
style that spreads from person to person within a culture.) rather
than an organic disease process. As Ross et al 1999 states, =93Meme=94 is
a particularly apt term for disease conceptions that induce
psychosomatic illness. The less medicine knows about the physical
process the more likely some researchers are to view it as iatrogenic
(harm caused by doctors - although psychiatrists are doctors as well)
or psychosomatic. Like fatigue, pain is not well understood at this
time, but the knowledge base is expanding.
Curr Rheumatol Rep. 2011 Aug 11. [Epub ahead of print]
Evidence for Shared Pain Mechanisms in Osteoarthritis, Low Back Pain,
and Fibromyalgia.
Staud R.
Division of Rheumatology and Clinical Immunology, University of
Florida, P.O. Box 100221, Gainesville, FL, 32610-0221, USA,
staudr@ufl.edu.
Abstract
Osteoarthritis (OA), low back pain (LBP), and fibromyalgia (FM) are
common chronic pain disorders that occur frequently in the general
population. They are a significant cause of dysfunction and
disability. Why some of these chronic pain disorders remain localized
to few body areas (OA and LBP), whereas others become widespread (FM)
is unclear at this time.
Genetic, environmental, and psychosocial factors likely play an important r=
ole.
Although patients with OA, LBP, and FM frequently demonstrate
abnormalities of muscles, ligaments, or joints, the severity of such
changes is only poorly correlated with clinical pain.
Importantly, many patients with these chronic pain disorders show
signs of central sensitization and abnormal endogenous pain
modulation. Nociceptive signaling is actively regulated by the central
nervous system to allow adaptive responses after tissue injuries.
Thus, abnormal processing of tonic peripheral tissue impulse input
likely plays an important role in the pathogenesis of OA, LBP, or FM.
Tonic and/or intense afferent nociceptive barrage can result in
central sensitization that depends on facilitatory input from
brainstem centers via descending pain pathways to the spinal cord.
Abnormal endogenous control of these descending pathways can lead to
excessive excitability of dorsal horn neurons of the spinal cord and
pain.
Ineffective endogenous pain control and central sensitization are
important features of OA, LBP, and FM patients.
PMID: 21833699
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