Disability and Impairment in Fibromyalgia Syndrome: Possible Pathogenesis and Etiology

A rehabilitation perspective is applied to Fibromyalgia Syndrome. There is consistent documentation in the literature of symptoms that could be defined as impairments, but the tender point concept is now seriously questioned, indicating a central disturbance in pain modulation, even though peripheral factors could start the process. Etiology is very seldom investigated and there is a need for conclusive epidemiological studies mapping risk factors and population differences. We suggest that when the disease process starts, the consequences in forms of impairments and disabilities reinforce the condition. This is supported by treatment studies indicating the best results by educational, multimodal programs.