Reply to Quintner and Cohen.

نویسنده

  • Robert D Gerwin
چکیده

I thank Drs. Quintner and Cohen for their interest in my editorial [1] about the study by Albrect et al. [2]. Drs. Quintner and Cohen have raised several concerns about my discussion of the implications of that study, especially of the concept that peripheral nociception by myofascial trigger points initiates central sensitization. They object to the idea that peripheral nerve sensitization is the fundamental “driver” of, as they put it, all possible somatic mechanisms of pain in fibromyalgia, which they claim is found in the editorial. I agree that this idea is extreme and is incorrect. However, my editorial states only that “peripheral nociceptive sites play an important role in initiating and maintaining pain . . . Pain is the outcome of a complex interplay between . . . central modulation and peripheral input.” However, Albrecht et al. [2] in their article do discuss in detail the implications of their work on some of the many manifestations of fibromyalgia, specifically fatigue, sleep, and cognition, through the potential of reduced blood flow to skeletal muscle caused by shunting blood from muscle to glaborous skin during exercise. The central issue raised by Quintner and Cohen is the role that active peripheral nociception plays in chronic widespread pain. This is a role that they doubt exists.

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عنوان ژورنال:
  • Pain medicine

دوره 15 4  شماره 

صفحات  -

تاریخ انتشار 2014