Investigating the transition from chronic low back or neck pain to widespread pain and fibromyalgia

Chronic low back pain, chronic neck pain, widespread pain (WSP), and fibromyalgia (FM) may share a common mechanism of central sensitization. Many individuals with WSP or FM, and some with chronic regional spinal pain (CRSP), show altered pain processing consistent with this neuroplastic change. Recent research suggests that some people with CRSP later develop WSP or FM, but the risk factors driving this transition remain unclear. This study followed 2,256 patients previously evaluated for chronic spinal pain to determine how often they progressed to WSP or FM and to identify predictors of this shift. Understanding these risk factors may help clinicians identify high‑risk patients earlier and intervene to prevent worsening pain and disability.