May/June 2012 that the lesion leading to pain
occurred within the CNS�either
spinal cord or brain. More recently,
however, the term has expanded to
describe any CNS dysfunction or
pathology that may be contributing
to the development or maintenance
of chronic pain.1
Another term that has often been used to describe this same phe-
nomenon is �central sensitization.�.
�Central pain,� (or central sensiti-
zation) was originally thought to be
confined to individuals with idio-
pathic or functional pain syndromes,
such as fibromyalgia (FM), head-
ache, irritable bowel syndrome
(IBS), temporomandibular joint dis-
order (TMJD), and interstitial cys-
titis (IC).2 These pain syndromes
have been shown to be familial/
genetic (e.g., the risk of develop-
ing FM is 8x higher in first degree
relatives of patients with FM) and
to co-aggregate in individuals and
families.1,3 This type of pain often
co-aggregates with other centrally-
mediated symptoms such as fatigue,
memory difficulties, and mood dis-
turbances..4,5 Recent twin studies
support a genetic basis of pain as
well as this cluster of co-aggregat-
ing symptoms.6,7 Even if individuals are identified as having a new onset of a regional pain syndrome (e.g., Interstitial Cystis), closer questioning reveals very high rates of pain in other body regions, and somatic symptoms other than pain.8 Evidence sug-gests that what is often labeled as a single chronic regional pain syn-drome is upon closer evaluation a chronic multisymptom illness, where the pain merely occurs in different body regions at different points in time, and is given different names by different sub-specialists focusing on �their region� of the body.1,5,9,10 The symptoms experienced by indiv ��Յ�́ݥѠ�����Ʌ��������帵�ɽ��́��ٔ������ݕ������Ʌ�ѕȵ�镐��������ͥ�Ё����ձѥ������������������ݥѠ�����������ɕ�Ё���������ѥ������ѽ�䁽�������������䁉�����ɕ����̤������ѡ������ѕȁ�����������ɥ���ͽ��ѥ�����ѽ�̀���������ѥ�Ք��ͱ���������ɉ����̰������䁑�����ձѥ�̤�İ�����́I���ɑ����ѡ������ѕɥ��������������ɥ���ͽ��ѥ�����ѽ�̰��́ݕ����́�����ȁѡ��������ѕ��Ʌѕ́����������ͽɑ��̰�ѡ������������ѡ�������ѡ����ݥѡ���ѡ�͔�����Ʌ��������хѕ́�́ѡ�Ё�����Ʌ��䁅�ѥ������ɽ�Ʌ�͵��ѕ�́ѡ�Ѐ)�ɔ����ݸ�Ѽ��������ɵ����������������䁄�ɽ���������ͥ���ѡ����������ѡ�͔������ѥ��̀��������܁��ɕ�������ɥ���� ��͕ɽѽ���쁡�������х��є��MՉ�х����@����ͼ������ɽ�����Ёɽ��́�������ɽ������ͱ���������������ѹ��̰��ь�İ�Ё%������ѥ���Ѽ�ѡ����Ց䁽�����ѽ��������́�������Ʌ��������хѕ̰�ݔ���ٔ������ͥ��������Ё��م���́�����ȁչ����х�����������ɽ�����������ѡ�����̸ͥ��ф��ɽ���Յ�Ѥ�хѥٔ�͕�ͽ��ѕ�ѥ����EMP�������չ�ѥ��������ɽ����������Ց��́�՝���Ёݥ�������٥�Յ��مɥ�ѥ���������������͕�ͽ��͕�ͥѥ٥��ѡ�Ё����ɕ́Ѽ��������͡��������ɥ�Եѥ�����ɽ�́��ݥ���مɥ��䁽����ɽ����������хѕ̰�ݥѠ����Չ͕Ё��������٥�Յ�́������她�����M���ɕ�͕��ٽ�յ������ɽ�P��ȁ����������܁ѡ�����������ɐ������ȁ�Ʌ����ɽ���͕́�����ͥ����̸Ḭ̇�Դ�܁M�������ѡ����̵�ɕє������ѥ��́���ͥ�ѕ�ѱ䁥����ѥ�����Ѽ���ٔ�ѡ�͔����Ʌ�ѕɥ�ѥ�́����Ց��4��% L��Q5)��������ѡ�����܁�����������ѕ�ͥ�������������%�������ձٽ�幥������ HE PROTOTYPICAL CENTRAL
PAIN STATE, FM, MAY HAVE
PERIPHERAL CONTRIBUTIONS. Since fibrositis became fibromyal-
gia in the 1970�s, the predominant
focus in FM has been on CNS 8 Fibromyalgia & Chronic Pain Life RESEARCH ADVOCACY