Which mechanism is proposed as a contributing cause of fibromyalgia in current theories?

• A. Central sensitization
• B. Abnormal levels of substance P and glutamate
• C. Genetics
• D. Stressors

Answer: (A)

Central sensitization is the mechanism most consistently implicated in fibromyalgia. It means the nervous system, especially in the spinal cord and brain, becomes unusually responsive to input, so normal signals are amplified and even non-painful stimuli can feel painful. This leads to widespread pain, tender points, and heightened sensitivity that persist beyond an injury or local issue.

In fibromyalgia, there’s enhanced excitability of neurons in pain pathways, increased activity of excitatory neurotransmitters in those circuits, and a reduction in the brain’s ability to dampen pain signals. Functional imaging often shows greater activation in brain regions that process pain, supporting this idea. While factors like neurotransmitter changes or genetic and psychosocial influences can modulate risk or symptom severity, central sensitization provides the common mechanism that explains the widespread and amplified pain seen across patients.