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. 38 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,” Ji et al, Anesthesiology, 2018.
- “Brain glial activation in fibromyalgia - A multi-site positron emission tomography investigation,” Albrecht et al, 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:
- Cannabidiol (CBD) products for pain: ineffective, expensive, and with potential harms. Moore 2023 J Pain.
- Inciting events associated with lumbar disc herniation. Suri 2010 Spine J.
- Prediction of an extruded fragment in lumbar disc patients from clinical presentations. Pople 1994 Spine (Phila Pa 1976).
- Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. Konstantinou 2015 BMC Musculoskelet Disord.
- Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Kuyken 2022 Evid Based Ment Health.