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Fibromyalgia, a chronic, widespread pain in muscles and soft tissues accompanied by fatigue, is a fairly common condition
that does not manifest any structural damage in an organ. Twenty-five years ago, Muhammad B. Yunus, MD, and colleagues published
the first controlled study of the clinical characteristics of fibromyalgia syndrome.
That seminal article, published in Seminars in Arthritis and Rheumatism, led directly to formal recognition of this disease
by the medical community. In the June 2007 issue of Seminars in Arthritis and Rheumatism, Dr. Yunus once again makes an enormous
contribution to the field of chronic pain and fatigue by meticulously synthesizing and interpreting the extensive body of
scientific literature on fibromyalgia and his own insights into the concept of central sensitivity syndromes (CSS).
Fibromyalgia, affecting approximately 2% of the US population, is an example of a class of maladies called CSS. These diseases
are based on neurochemical abnormalities and include irritable bowel syndrome, migraine and restless legs syndrome.
Incorporating a critical review of over 225 publications and the author’s broad experience in fibromyalgia and related
diseases, Dr. Yunus describes 13 separate conditions that are related to central sensitization (CS), where the central nervous
system (spinal cord and brain) becomes extremely sensitized on certain parts of the body, so that even mild pressure or touch
would cause much pain. Such hypersensitivity may also be associated with other symptoms such as poor sleep and fatigue.
According to Dr. Yunus, “CSS are the most common diseases that are based on real neurochemical pathology and cause real
pain and suffering. In some patients stress and depression may contribute to the symptoms but they are all based on objective
changes in the central nervous system.”
Dr. Norman L. Gottlieb, Editor of Seminars in Arthritis and Rheumatism, believes that this article "advances our understanding
of fibromyalgia, unifies and advances concepts, and suggests that this and several other common disorders have much in common
in terms of their biopsychosocial development. This, hopefully, will expand both clinical and research interest in this group
of diseases and lead to advances in therapy for many of them."
In an accompanying editorial John B. Winfield, MD, comments, “Without question, Muhammad Yunus is the father of our
modern view of fibromyalgia…. Yunus, who took a rather more biological approach to fibromyalgia in the past, now emphasizes
a biopsychosocial perspective. In my view, this is tremendously important because it is the only way to synthesize the disparate
contributions of such variables as genes and adverse childhood experiences, life stress and distress, posttraumatic stress
disorder, mood disorders, self-efficacy for pain control, catastrophizing, coping style, and social support into the evolving
picture of central nervous system dysfunction vis-a-vis chronic pain and fatigue ….Science and medicine now have a rational
scaffolding for understanding and treating chronic pain syndromes previously considered to be ‘functional’ or
‘unexplained.’ …Neuroscience research will continue to reveal the mechanisms of CS, but only if informed
through a biopsychosocial perspective and with the interdisciplinary collaboration of basic scientists, psychologists, sociologists,
epidemiologists, and clinicians.”
Dr. Yunus concludes that CSS is an important new concept that embraces the biopsychosocial model of disease. He advocates
further critical studies to fully test this concept which seems to have important significance for new directions for research
and patient care involving physician and patient education. “Each patient, irrespective of diagnosis,” says Dr.
Yunus, “should be treated as an individual, considering both the biological and psychosocial contributions to his or
her symptoms and suffering.”
The article is “Fibromyalgia and Overlapping Disorders: The Unifying Concept of Central Sensitivity Syndromes”
by Muhammad B. Yunus, MD, Professor of Medicine, Section of Rheumatology, The University of Illinois College of Medicine at
Peoria, Peoria, Illinois. The accompanying editorial is “Fibromyalgia and Related Central Sensitivity Syndromes: Twenty-Five
Years of Progress” by John B. Winfield, MD, University of North Carolina School of Medicine. Both appear in the June
issue of Seminars in Arthritis and Rheumatism, Vol. 36:6, published by Elsevier.
Source Article http://www.innovations-report.de/html/berichte/medizin_gesundheit/bericht-86441.html
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