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Is fibromyalgia (FM) a distinct clinical entity? The clinical investigator's evidence

  [ 38 votes ]   [ Discuss This Article ] • September 16, 1999

SUBJECTIVE: Chronic widespread pain with multiple tender
points (fibromyalgia syndrome) is a common clinical
presentation. Criteria for inclusion of fibromyalgia patients
into research studies have led to a medical model which
integrates symptoms, signs, epidemiology, pathogenesis,
responses to treatment, and prognosis. Controversy regarding
fibromyalgia relates mostly to issues of compensation.

THEORETICAL: The diagnosis of fibromyalgia has been challenged
as an inappropriate extraction from an epidemiological
continuum of subjective discomfort. There are many conditions
in which normally distributed measures exhibit distinctly
unique outcomes at their extremes.

fibromyalgia patients exhibit lowered pain thresholds, the
process of nociception was studied. Samples of fibromyalgia
urine, blood, and spinal fluid disclosed abnormalities
consistent with a biomedical model of failed neuroregulatory
inhibition, altered nociception, central sensitization, and
allodynia. All three views support fibromyalgia as a distinct
clinical syndrome deserving of informed medical care and
continued research to better understand chronic widespread

Russell IJ

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