Fibromyalgia syndrome: Diagnosis, pathogenesis, and management

The fibromyalgia syndrome previously was considered to be a psychosomatic pseudo-disorder with objective basis. It is now readily diagnosed by established clinical criteria. While the syndrome was once believed to lack any abnormal laboratory values, it is now known to exhibit low platelet serotonin and low red blood cell ATP, plus elevated levels of substance P and nerve growth factor in the cerebrospinal fluids of affected individuals. Fibromyalgia is becoming the human model for the study of aberrant nociception. These findings indicate that fibromyalgia should be diagnosed prospectively, and that physiologically relevant laboratory abnormalities may soon lead to a more specific treatment.