This assignment requires a cross-post (insightful response) supported by an additional reference in APA style to a initial post. Below is the post I chose for the response.

This assignment requires a cross-post (insightful response) supported by an additional reference in APA style to a initial post. Below is the post I chose for the response.
Fibromyalgia is characterized by tenderness throughout the body, chronic fatigue, diffuse joint and muscle pain. Areas of increased sensitivity to touch are known as tender points, but in fibromyalgia tender points occur in a widespread manner (Huether er al, 2019). Though the pathophysiology has not been discovered yet, research is pointing to genetic factors and environmental exposure, like stress, to the development of FM. Diagnosis of this disease is dependent on the differential diagnoses since chronic generalized pain and fatigue are also present in other musculoskeletal disorders (Huether et al, 2019). It takes a highly individualized plan of care which includes pharmacological and non-pharmacologic therapies to produce the best outcome.
The etiology and pathogenesis of Fibromyalgia (FM) are still not fully understood but scientists do know that it is related to a pain-processing problem in the brain that causes hypersensitivity to pain. FM is shown to affect mono-aminergic neurotransmission; this leads to elevated levels of glutamate and substance p and decreased levels of serotonin and norepinephrine in the spinal cord (Siracusa et al, 2021). Therefore, FM is considered a central sensitivity syndrome. Studies also confirm that neurogenic-derived inflammatory processes that release chemokine and cytokines are another factor responsible for sensitive nociceptors and chronic muscle pain in FM (Siracusa et al, 2021). It is a complex syndrome that includes many factors such as neuroendocrine factors, genetic predisposition, oxidative stress, and environmental and physical changes that are involved in pathophysiology.
FDA approved three medications, Pregabalin, Duloxetine, and Milnacipran for FM indication but current guidelines published show that treatment needs to involve a multidisciplinary approach of both pharmacological and complementary modalities (Ablin & Tzadok, 2020). Studies have shown that Pregabalin (Lyrica) decreases glutamatergic activity in the insular (Siracusa et al, 2021). Both Duloxetine and Milnacipran are serotonin-noradrenaline reuptake inhibitors that improve pain in FM patients. Medications that modulate levels of CNS neurotransmitters like serotonin and noradrenaline have the potential to reduce central sensitization (Ablin & Tzadok, 2020). Antidepressants are being used as well but evidence shows varying efficacy; data suggests that FM patients are not compliant when it comes to long-term pharmacotherapy (Siracusa et al, 2021). More research is emerging on the use of cannabinoids as a new strategy to treat FM patients with sleep abnormalities. In Canada, their medical guidelines support the use of cannabinoids as a therapeutic option (Ablin & Tzadok,