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While studies attempting to localize the pathology in FMS to peripheral tissues have failed in showing any abnormalities in muscle tissue, Staud and coworkers did show that enhanced central pain processing can occur via continued peripheral muscle afferent input, Their study demonstrated that muscle lidocaine injections increased local pain thresholds and decreased remote secondary heat hyperalgesia in fibromyalgia patients, emphasizing the important role of peripheral impulse input in maintaining central sensitization

This may not be apparent as people learn to live with conditions that develop over a lifetime, or put it them down to age