Patients with higher fibromyalgia survey scores describe a more negative pain phenotype preoperatively, including more opioid use, higher pain scores, higher levels of anxiety and depression, and lower physical function. It is known that patients with fibromyalgia have decreased mu-opioid receptor binding availability and higher endogenous opioid levels. These data suggest that exogenous opioids may not be effective in patients with a fibromyalgia-like or centralized pain phenotype.