Is fibromyalgia a generalized reflex sympathetic dystrophy?
Fibromyalgia and reflex sympathetic dystrophy share defining characteristics, namely chronic pain and allodynia, as well as other important clinical features such as onset after trauma, female predominance, paresthesias, vasomotor instability, response to sympathetic blockade and anxiety/depression. Recent research using heart rate variability analysis demonstrated that patients with fibromyalgia have changes consistent with relentless circadian sympathetic hyperactivity. I propose that fibromyalgia is a sympathetically maintained pain syndrome in which ongoing sympathetic hyperactivity sensitises the primary nociceptors and induces widespread pain and allodynia.
Rheumatology Department, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano no. 1, 14080 México D.F. Mexico. mmlavin@infosel.net.mx
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D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D005356:Fibromyalgia / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology; D012019:Reflex Sympathetic Dystrophy / Q000150:complications* / Q000175:diagnosis; D012737:Sex Factors