Journal Mobile

GO Littlejohn
Journal Issue: 
Volume 35: Issue 4: 2005




Acute  pain  within  the  various  components  of  the  musculoskeletal system  is  a  cardinal  symptom  of  the  pathophysiological  processes  involved  with tissue  damage,  disease,  or  dysfunction.   These  disorders  are  generally  well-characterised  and  management  usually  associated  with  good  symptomatic  and functional outcomes.  Immediate activation of an inbuilt and hard-wired basic pain system serves a primary protective function to the host. Another system, perhaps best described as an advanced pain system, augments, amplifies, and extends the role of the pain system to other functions.  Emotional distress has a potent effect on this process and drives a series of events that results in altered ‘downstream’ musculoskeletal symptoms and function.  Under these circumstances chronic pain states may arise and may particularly involve the musculoskeletal tissues.

Fibromyalgia  syndrome  is  used  here  as  an  example  of  a  common  chronic musculoskeletal pain syndrome, characterised by widespread pain and tenderness, in  order  to  allow  for  discussion  of  the  biopsychosocial  inputs  that  must  be addressed  to  provide  the  best  clinical  outcome. Emphasis  is  placed  on understanding the nature of these problems, particularly to enhance reversibility and hence improve outcomes.