Widespread Pain and Fibromyalgia

While we have increasing understanding of the mechanisms of musculoskeletal pain, this knowledge has translated into treatments that so far have left many patients and healthcare providers dissatisfied. This is particularly true for fibromyalgia syndrome (FM) and chronic widespread pain that afflicts up to 20% of the general population, mostly women. In this course, the epidemiology and clinical characteristics of FM, defined by widespread pain, tissue tenderness, and a host of somatic symptoms, will be briefly reviewed. In addition, new research over the last 10 years has identified a number of peripheral and central nervous system abnormalities. Some findings are consistent with central and peripheral sensitization; however, most of the available treatments have focused on central pain abnormalities. Much of the most recent evidence for abnormal pain mechansims comes from the functional magnetic brain and spinal cord imaging of FM patients. A brief overview of peripheral/central mechanisms and treatments for FM will be provided, along with findings regarding abnormal connectivity between sensory and affective brain areas. The session will conclude with a summary of findings and recommendations for a comprehensive approach to the assessment and treatment of FM focusing on pain but also integrating fatigue, sleep abnormalities, and mood. (Recorded at PAINWeek 2018)