Targeting fibromyalgia pain: brain-spinal cord and peripheral contributions

Fibromyalgia (FM) is a complex chronic pain syndrome with a well-defined clinical phenotype that results from disordered central pain-related mechanisms. The etiology is multifaceted with links to genetic factors, personality, psychological distress, environmental triggers and peripheral musculoskeletal function. Central brain and spinal cord 'top-down mechanisms dominate the pathophysiology of FM. We review the disordered pain-related neurological processes that are present in FM and discuss treatments that target these relevant mechanisms.