1IntroductionIn this issue of the Scandinavian Journal of Pain Heinrich Wernze and Thomas Herdegen  report that spironolactone shows beneficial long-term effects on pain, mood, and quality of life in 50% of the 31 fibromyalgia patients they treated with spironolactone for 12 months. This review addresses two questions: why would spironolactone be effective in reducing fibromyalgia-related symptoms and what is the role of case series in modern medicine.2FibromyalgiaFibromyalgia is a common pain syndrome with a point prevalence of 1–5%. The majority of fibromyalgia patients are female. The syndrome is often preceded by local pain problems such as headache, neck and back pain, which then develop to widespread pain. Sleep disturbance and obesity are also related to fibromyalgia, which often coincides with other symptoms or diseases such as migraine, asthma, and irritable bowel disease. Anxiety and depression are common co-morbidities with fibromylgia as is the case with other chronic pain conditions. The pathophysiology of fibromyalgia is slowly being revealed. Dysfunction of the stress axis and descending pathways of endogenous pain inhibition, aberrant brain networks and peripheral small fibre neuropathy  have been shown to be related to fibromyalgia.The treatment of fibromyalgia consists of exercise, physiotherapy, and pharmacological management. However, the
Scandinavian Journal of Pain – de Gruyter
Published: Apr 1, 2014
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