Fibromyalgia is an increasingly recognizable syndrome of central sensitization. It is characterized by widespread musculoskeletal pain in the body, sensitivity to pressure on soft tissue (ligaments, joints and muscles), fatigue, sleep disturbances, and affected emotions. The symptoms become chronic, can persist for months, and reoccur periodically for years. It is estimated to affect 1.5 to 4% of the population of which 80% are women. (Pain: 153 (2012) 1495-1503).
The cause of fibromyalgia (idiopathic pain syndrome) is not known. It is possible though that several causative factors are involved (genetic, environmental). Many patients link the onset of the syndrome to a stressful or traumatic event. On the other hand, a large number of studies demonstrate the involvement of the central nervous system in the pathophysiology of the syndrome (neuroimaging studies have found changes in: cerebral function, brain structure, phenotype, biochemistry of neurons, and the concentration of neurotransmitter substances). In recent years, fibromyalgia has become considered a functional disorder where neurons are in a state of hyper-excitability.
The recommended treatment approach is multifactored and includes: informing and educating the patient, treatment with anti-depressants (SSRIs, SNRIs) and anticonvulsants, exercise, hand massage, relaxing and stress-monitoring techniques, and cognitive behavioral therapy. The beneficial synergistic effect of acupuncture and electro-acupuncture in the treatment of the syndrome has also been recognized.
The 9 pairs of sensitive painful areas (tender points) that meet the criteria for fibromyalgia according to the American College.