Unravelling Fibromyalgia

Oh for the dream of precision medicine in the world of fibromyalgia (FM)! But how can one possibly apply precision medicine to a condition with the character of a chameleon? Why do we say FM is like a chameleon? The suffering experienced by persons with FM is camouflaged by an outside appearance of normalcy, and the symptoms of FM come and go … [Read more...]

Small fibre neuropathy in Fibromyalgia: cause or consequence?

Dan Clauw recently wrote an insightful editorial for Pain[1], in which he highlighted an important finding about the idea that people with fibromyalgia show signs of ‘small fibre neuropathy’.  Changes in intra-epidermal nerve fibres (‘small fibres’) have been shown in many clinical conditions, including conditions that are characterised by chronic … [Read more...]

Can Pain Neuroscience Education Improve Endogenous Pain Inhibition?

Many chronic musculoskeletal pain disorders are characterized by the presence of central sensitization, which implies that the central nervous system is in a hypersensitive state in those who suffer from these disorders. Sensitivity to pain results from the outcome of the battle between pathways which facilitate the passage of nociceptive … [Read more...]

Tiny electrodes but big finding – is fibromyalgia a type of small fibre neuropathy?

Lorimer went to a splendid topical workshop at the World Congress on Pain. The workshop was about the relative contribution of periphal and central contributions to fibromyalgia. There were three speakers. This blog will focus on the first - Jordi Serra from Barcelona. Jordi is a neurologist and is doing some excellent work with … [Read more...]

Timing is everything

Human brain mapping doesn’t go back as far as one might think.  The first brain activation studies used positron emission tomography (PET) back in the late 1980s.   Functional magnetic resonance imaging, or fMRI, followed in the early 90s and went on to radically change neuroimaging [1]. Given that it’s such early days for brain mapping, it … [Read more...]