An evolutionary stress-response hypothesis for chronic widespread pain (fibromyalgia syndrome)
Five articles on PainSci cite Lyon 2011: 1. A Deep Dive into Delayed-Onset Muscle Soreness 2. 35 Surprising Causes of Pain 3. The 3 Basic Types of Pain 4. Chronic, Subtle, Systemic Inflammation 5. A Rational Guide to Fibromyalgia
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
OBJECTIVE: The study aimed to seek a unifying biological basis for the phenomena encompassed in fibromyalgia syndrome (chronic widespread pain and associated morbidities).
SETTING: While much progress has been made in the last decade in understanding chronic widespread pain, its pathogenesis remains stubbornly obscure and its treatment difficult. Two themes are gaining currency in the field: that chronic widespread pain is the result of central sensitization of nociception, and that chronic pain is somehow related to activation of a global stress response.
DESIGN: In this article we merge these two ideas within the perspective of evolutionary biology to generate a hypothesis about the critical molecular pathway involved in chronic stress response activation, namely substance P and its preferred receptor, neurokinin-1 (NK-1R), which has many empirically testable implications.
CONCLUSION: Drawing on diverse findings in neurobiology, immunology, physiology, and comparative biology, we suggest that the form of central sensitization that leads to the profound phenomenological features of chronic widespread pain is part of a whole-organism stress response, which is evolutionarily conserved, following a general pattern found in the simplest living systems.
related content
- “Neuroinflammation and Central Sensitization in Chronic and Widespread Pain,” Ru-Rong Ji, Andrea Nackley, Yul Huh, Niccolò Terrando, and William Maixner, Anesthesiology, 2018.
- “Brain glial activation in fibromyalgia - A multi-site positron emission tomography investigation,” Daniel S Albrecht, Anton Forsberg, Angelica Sandström, Courtney Bergan, Diana Kadetoff, Ekaterina Protsenko, Jon Lampa, Yvonne C Lee, Caroline Olgart Höglund, Ciprian Catana, Simon Cervenka, Oluwaseun Akeju, Mats Lekander, George Cohen, Christer Halldin, Norman Taylor, Minhae Kim, Jacob M Hooker, Robert R Edwards, Vitaly Napadow, Eva Kosek, and Marco L Loggia, Brain Behav Immun, 2019.
Specifically regarding Lyon 2011:
- “Evolution, Stress and Fibromyalgia,” John Quintner, FMperplex.com.
- “Fibromyalgia and Neuroinflammation: Shall the Twain Ever Meet?,” John Quintner, FMperplex.com.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Association of Lumbar MRI Findings with Current and Future Back Pain in a Population-based Cohort Study. Kasch 2022 Spine (Phila Pa 1976).
- A double-blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component. Yousef 2013 Anaesthesia.
- Is Neck Posture Subgroup in Late Adolescence a Risk Factor for Persistent Neck Pain in Young Adults? A Prospective Study. Richards 2021 Phys Ther.
- Sudden amnesia resulting in pain relief: the relationship between memory and pain. Choi 2007 Pain.
- Photobiomodulation therapy is not better than placebo in patients with chronic nonspecific low back pain: a randomised placebo-controlled trial. Guimarães 2021 Pain.