Fibromyalgia (FM) is defined as the presence of both chronic widespread pain (CWP) and the finding of 11/18 tender points on examination. Painful areas are called tender points, and they are usually found in the soft tissue on the back of the neck, shoulders, chest, lower back, hips, shins, elbows, and knees. The pain then spreads out from these areas. The pain may feel like a deep ache, or a shooting, burning pain.
Chronic widespread pain patients have symptoms similar to Fibromyalgia patients, though less severe.1 Only about 20% of individuals in the population with CWP also have 11/18 tender points; these individuals are considerably more likely to be female, and have higher levels of psychological distress.3.
The HPA axis is the body's primary stress response system. Genetic variation in HPA axis genes such as SERPINA6 and CRHBP, have been associated with musculoskeletal pain; however, some of the associations were explained by other conditions like poor sleep quality and depression.[4, 5].
It has been hypothesized that the abnormal functioning of the HPA axis in musculoskeletal pain could be due stressors such as severe adverse events in early life, which have been shown to result in altered levels of neurotransmitters such as reduced serotonin levels, and reduced ACTH and CRH in response to stress. [6, 7]
Related to:
Fibromyalgia, tender points, neuropathic pain syndrome, musculoskeletal pain