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

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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