Fibromyalgia (FM) syndrome, a problem of tautology

Fibromyalgia syndrome is generally taken to denote a clinical state

of widespread musculoskeletal pain, stiffness, and fatigue but

its pathophysiology, physical and psychological, is unknown,

and the nature of the diagnostically mandatory “tender points”

remains obscure. Diagnostic criteria convey no

pathophysiological insight and they have been “validated” via

a circular argument in which the evidence on which the

construct is based is taken as proof of its veracity. The

concept of fibromyalgia syndrome is valid only in the sense

that it includes all possibilities. An alternative approach to

this very real clinical presentation is via secondary

hyperalgesia.

Cohen ML, Quintner JL

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