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An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Fibromyalgia Conundrum

Manuel Martinez-Lavin, MD  |  Issue: July 2008  |  

Traditionally, the rheumatology community has demonstrated boldness in the investigation of puzzling illnesses such as vasculitis or lupus. FM poses a greater challenge because its understanding may require a paradigm shift from reductionism to holism.

Future research will hopefully define—and untangle—the abnormal autonomic-nociceptive short circuits that lead to central sensitization. In the meantime, only a broad alliance of patients, health providers, researchers, and government agencies would be able to face this major health problem among contemporary women.

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Dr. Martinez-Lavin is chief of the rheumatology department at the National Institute of Cardiology in Mexico City and professor of rheumatology at the National Autonomous University of Mexico.

References

  1. Burckhardt CS, Clark SR, Bennett R. Fibromyalgia and quality of life: a comparative analysis. J Rheumatol. 1993;20:475-479.
  2. Dobson R. Doctors rank myocardial infarction as most “prestigious” disease and fibromyalgia as least. BMJ. 2007;335:632-633.
  3. Martinez-Lavin M, Infante O, Lerma C. Hypothesis. The chaos and complexity theory may help our understanding of fibromyalgia and similar maladies. Semin Arthritis Rheum. 2008;37:260-264.
  4. Goldberger. Non-linear dynamics for clinicians: chaos theory, fractals, and complexity at the bedside. Lancet. 1996;347:1312-1314.
  5. Glass L, Mackey MC. From Clocks to Chaos, the Rhythms of Life. Princeton, N.J.: Princeton University Press 1988.
  6. Waldrop M. Complexity: The Emerging Science at the Edge of Order and Chaos. New York, N.Y.: Touchstone 1992.
  7. Martinez-Lavin M. Biology and therapy of fibromyalgia. Stress, the stress response system, and fibromyalgia. Arthritis Res Ther. 2007;9:216.
  8. Pikkujämsä SM, Mäkikallio TH, Sourander LB, et al. Cardiac interbeat interval dynamics from childhood to senescence: Comparison of conventional and new measures based on fractals and chaos theory. Circulation. 1999;100:393-399.
  9. Carville SF, Arendt-Nielsen S, Bliddal H, et al. EULAR evidence based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis. 2008;67:536-541.

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