the clinical concept of fibromyalgia as a changing paradigm in the past 20 years纤维肌痛的临床概念范式在过去20年里的变化.pdfVIP

Hindawi Publishing Corporation Pain Research and Treatment Volume 2012, Article ID 184835, 8 pages doi:10.1155/2012/184835 Review Article The Clinical Concept of Fibromyalgia as a Changing Paradigm in the Past 20 Years Mary-Ann Fitzcharles1, 2, 3 and Muhammad B. Yunus4 1 Division of Rheumatology, McGill University, Montreal, QC, Canada H3G 1A4 2 Alan Edwards Pain Management Unit, McGill University Health Center, Montreal, QC, Canada H3G 1A4 3 Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada H3G 1A4 4 Section of Rheumatology, Department of Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA Correspondence should be addressed to Mary-Ann Fitzcharles, mary-ann.fitzcharles@muhc.mcgill.ca Received 20 April 2011; Accepted 25 July 2011 Academic Editor: Chad Boomershine Copyright © 2012 M.-A. Fitzcharles and M. B. Yunus. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Fibromyalgia (FMS) is a valid clinical condition that affects 2%–4% of the population with a pivot symptom of widespread body pain. The cause and cure of FMS are as yet unknown. The concept of FMS has evolved over the past two decades to incorporate symptoms beyond pain as contributing to the global spectrum of suffering. FMS is now recognized to be grounded in the neurological domain with evidence of dysregulation of pain processing. Appreciation of the neurophysiologic mechanisms operative in FMS has contributed to rational treatment recommendations, although a “gold standard treatment” does not currently exist. Ideal treatments