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Fibromyalgia is a complicated and multifaceted disorder marked by widespreadchronic pain, fatigue, and muscle tenderness. Current explanations for thepathophysiology of this condition include the Central Sensitization Theory,Cytokine Inflammation Theory, Muscle Hypoxia, Muscle Tender Point Theory, andSmall Fiber Neuropathy Theory. The objective of this review article is toexamine and explain each of these current theories and to provide a backgroundon our current understanding of fibromyalgia. The medical literature on thisdisorder, as well as on the roles of functional magnetic resonance imaging(fMRI) and elastography as diagnostic tools, was reviewed from the 1970s toearly 2023, primarily using the PubMed database. Five prominent theories offibromyalgia etiology were examined: 1) Central Sensitization Theory; 2)Cytokine Inflammation Theory; 3) Muscle Hypoxia; 4) Muscle Tender Point Theory;and 5) Small Fiber Neuropathy Theory. Previous fMRI studies of FMS haverevealed two key findings. First, patients with FMS show altered activationpatterns in brain regions involved in pain processing. Second, the connectivitybetween brain structures in individuals diagnosed with FMS and healthy controlsis different. Both of these findings will be expanded upon in this paper.  The article also explores the potential for future research in fibromyalgiadue to the advancements in fMRI and elastography techniques, such as shear waveultrasound. Increased understanding of the underlying mechanisms contributingto fibromyalgia symptoms is necessary for improved diagnosis and treatment, andadvanced imaging techniques can aid in this process.

Functional Magnetic Resonance Imaging Changes and Increased Muscle  Pressure in Fibromyalgia: Insights from Prominent Theories of Pain and Muscle  Imaging