How to Evaluate the Pain of Fibromyalgia Syndrome : FMS as a Typical Model of Chronic Pain(Symposium/The Mechanism and Practice of Chronic Pain)

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  • Murakami Masato
    Department of Psychosomatic Internal Medicine, Nihon University Itabashi Hospital:Department of Respiratory Medicine, Nihon University School of Medicine
  • Matsuno Toshio
    Department of Psychosomatic Internal Medicine, Nihon University Itabashi Hospital
  • Kim Woesook
    Department of Psychosomatic Internal Medicine, Nihon University Itabashi Hospital:College of Nursing Art and Science, University of Hyogo
  • Koike Kazuyoshi
    Department of Psychosomatic Internal Medicine, Nihon University Itabashi Hospital:Department of Oral Diagnostics, Nihon University School of Dentistry
  • Inoue Mikichika
    Department of Psychosomatic Internal Medicine, Nihon University Itabashi Hospital:Department of Respiratory Medicine, Nihon University School of Medicine
  • Miura Katsuhiro
    Department of Psychosomatic Internal Medicine, Nihon University Itabashi Hospital:Department of Hematology and Rheumatology, Nihon University School of Medicine
  • Hanaoka Keiko
    Department of Psychosomatic Internal Medicine, Nihon University Itabashi Hospital:Kichijoji-dori Hanaoka Clinic
  • Ebana Shoichi
    Department of Psychosomatic Internal Medicine, Nihon University Itabashi Hospital:Department of Psychosomatic Internal Medicine, Yokohama Rosai Hospital
  • Hashimoto Shu
    Department of Respiratory Medicine, Nihon University School of Medicine

Bibliographic Information

Other Title
  • 線維筋痛症の痛みをどうとらえるか : 慢性疼痛のモデル的疾患として(シンポジウム:慢性疼痛の基礎と臨床,2008年,第49回日本心身医学会総会(札幌))
  • 線維筋痛症の痛みをどうとらえるか--慢性疼痛のモデル的疾患として
  • センイキンツウショウ ノ イタミ オ ドウ トラエル カ マンセイ トウツウ ノ モデルテキ シッカン ト シテ

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Fibromyalgia Syndrome (FMS) is one of the common diseases among the chronic pain disorders characterized by long-lasting generalized pain of the fibro-muscular system and various unidentified complaints. Since the onset and clinical course of FMS involve many psychosocial stress factors and disturbed the endocrine system of womanhood in addition to genetic and physiological factors, it is very important to consider the psychosomatic background of the patient with FMS. Ninety percent of the patients were found to have experienced physical strains such as surgery, accident, trauma, delivery, physical overload and excessive exercise. Remarkable personality traits such as anxiety, fear, anger, obsession, depression and sorrow were observed from clinical interviews and psychological tests. For the physiological background, the amount of urinary metabolites such as VMS, MHPG or 5HIAA showed significantly lower than control healthy subjects, which was very similar to the patients with depression. It is suggested that the dysfunction of serotonin and a noradrenalin-mediated descending pain control system and contraction of muscular and vascular systems followed by circulatory disorders may be involved in chronic pain of FMS. Also the low level of serum acyl-carnitine may explain the psychological and physical exhaustion and accumulated fatigue of FMS. As for medication, ordinary analgesics such as NSAIDs are not effective but antidepressants such as SSRI or SNRI often show a remarkable effect. Anticonvulsants and Kampo herbal medicine have also been reported to be effective for chronic pain of FMS. To the problems of psychological stress and personality, counseling and advanced psychotherapy such as cognitive behavioral therapy (CBT) based on "the personal growth model" may be more important rather than "the medical model". Due to the above condition and situation, psychosomatic specialists will be likely to become main practitioners for the treatment of FMS

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