• Theoharis C Theoharides, Irene Tsilioni, Lauren Arbetman, Smaro Panagiotidou, Julia M Stewart, Rae M Gleason, and Irwin J Russell.
• Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, Boston, Massachusetts (T.C.T., I.T., L.A., S.P., J.M.S.); Department of Internal Medicine, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts (T.C.T.); Department of Psychiatry, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts (T.C.T.); Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, Massachusetts (T.C.T.); National Fibromyalgia and Chronic Pain Association, Logan, Utah (R.M.G.); Fibromyalgia Research and Consulting, Arthritis and Osteoporosis Center of South Texas, San Antonio, Texas (I.J.R.) theoharis.theoharides@tufts.edu.
• J. Pharmacol. Exp. Ther. 2015 Nov 1; 355 (2): 255-63.

AbstractFibromyalgia syndrome (FMS) is a chronic, idiopathic condition of widespread musculoskeletal pain, affecting primarily women. It is clinically characterized by chronic, nonarticular pain and a heightened response to pressure along with sleep disturbances, fatigue, bowel and bladder abnormalities, and cognitive dysfunction. The diagnostic criteria have changed repeatedly, and there is neither a definitive pathogenesis nor reliable diagnostic or prognostic biomarkers. Clinical and laboratory studies have provided evidence of altered central pain pathways. Recent evidence suggests the involvement of neuroinflammation with stress peptides triggering the release of neurosenzitizing mediators. The management of FMS requires a multidimensional approach including patient education, behavioral therapy, exercise, and pain management. Here we review recent data on the pathogenesis and propose new directions for research and treatment. Copyright © 2015 by The American Society for Pharmacology and Experimental Therapeutics.

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