Fibromyalgia is a diffuse musculoskeletal pain disorder with unknown cause. Several factors contribute to its development, including genetic predisposition in combination with physical and emotional stressors. It was first described inFranceandEnglandin the mid-nineteenth century and it was termed “fibrositis.” Upon reviewing muscle biopsies of patients affected with the condition, the term was changed to “fibromyalgia,” as there is no evidence of inflammation in the muscles.

Fibromyalgia seems to be caused by a dysfunction of the way the neurotransmitters work in the pain system. A neurotransmitter is a substance released by nerve cells that transmits information across the nervous system. Please note in the diagram below that the pain system (the same as the nervous system) begins at the periphery (such as the hand), marked #1. The sensation of pain travels from the periphery to the spinal cord (#2), and then to the brain (#3). In a dysfunctional system, there is no balanced release of neurotransmitters, which results in increased pain sensation, also known as central sensitization. It is like increasing the volume on a radio by transmitting or passing increased pain signals.

Please refer to the following diagram of the pain system to visualize how it works.

Published with permission from Pfizer.

Published with permission from Pfizer.


Adahli E. Massey, MD, FACR