Editor's comment: Although most FM experts would not agree with the author's premise that “…fibromyalgia is most commonly associated with psychological trauma…,” the review's evaluation of the role neurogenic neuroinflammation may play in fibromyalgia seems to have some validity.

Abstract:

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Although fibromyalgia and complex regional pain syndrome (CRPS) have distinct clinical phenotypes, they do share many other features. Pain, allodynia and dysaesthesia occur in each condition and seem to exist on a similar spectrum. Fibromyalgia and CRPS can both be triggered by specific traumatic events, although fibromyalgia is most commonly associated with psychological trauma and CRPS is most often associated with physical trauma, which is frequently deemed routine or minor by the patient.

Fibromyalgia and CRPS also seem to share many pathophysiological mechanisms, among which the most important are those involving central effects. Nonetheless, peripheral effects, such as neurogenic neuroinflammation, are also important contributors to the clinical features of each of these disorders.

This Review highlights the differing degrees to which neurogenic neuroinflammation might contribute to the multifactorial pathogenesis of both fibromyalgia and CRPS, and discusses the evidence suggesting that this mechanism is an important link between the two disorders, and could offer novel therapeutic targets.

Source: Nature Reviews Rheumatology, August 4, 2015. By Geoffrey Littlejohn. Department of Medicine, Monash University, Monash Medical Centre, 246 Clayton Road, Clayton, VIC 3168, Australia.