Abstract
The term Central Sensitivity Syndromes (CSS) includes functional somatic syndromes with abnormal CNS activation during processing of pain perception. CSS in rheumatology include fibromyalgia (FM), chronic (idiopathic) low back pain (LBP), myofascial pain syndrome (regional soft tissue pain syndrome), and temporomandibular disorder (TMD).
Scientific approache to these CSS includes two main aspects: neuroimaging and molecular biology. Using methods of functional, spectroscopic and 3D magnetic resonance were found CNS abnormalities in somatosensory cortex and subcortical structures, especially in FM and chronic LBP.
Abnormalities in molecular biology are related especially to neuropeptides in cerebrospinal fluid and biogenic amines (i. e. neurotransmiters serotonine and norepinephrine) in synaptic transmission at spine; reuptake inhibition is an important aspect of therapy in a part of CSS. In FM and TMD was observed an important genetic variability, presented namely as simple nucleotid polymorphism.
Scientific progress and clinical experience modified the concept of FM from widespread pain categorization to multidimensional FM scale. Redefinition of FM was expressed in preliminary diagnostic criteria ACR/2010 and following modification (2011) in evaluation of any somatic symptoms.
In this connection should be accentuated, that namely comorbid FM with relation to rheumatoid arthritis, osteoarthritis and systemic lupus erythematosus is an actual problem in rheumatological practice.