ReviewClinical rheumatology2018
Fibromyalgia and small fiber neuropathy: the plot thickens!
Review in Clinical rheumatology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
39 citing papers in PubMed, 1 synthesis or guideline pooled it, 81 citations in OpenAlex.
- Aerobic Exercise Prescription for Pain Reduction in Fibromyalgia: A Systematic Review and Meta-Analysis.European journal of pain (London, England) · 2025Pooled it
- Surgical Neurolysis for Atypical Neuropathy Diagnosed via Physical Examination Significantly Improves Chronic Pain Despite Negative Workup.Plastic and reconstructive surgery. Global open · 2026Article
- Effect of different types of exercise in fibromyalgia syndrome: a network meta-analysis.BMC sports science, medicine & rehabilitation · 2026Article
- Small Fibre Pathology in Fibromyalgia: A review.Pain and therapy · 2025Review
- Diagnostic utility of deep tendon reflex responses in rectus femoris and triceps brachii in fibromyalgia: a clinical and electrophysiological study.Rheumatology international · 2025Article
- Evidence for spinal disinhibition as a pain-generating mechanism in fibromyalgia syndrome.Pain reports · 2025Article
- Article
- Integrating nociplastic pain into neuropathic pain framework: a proposal for a revised classification.Frontiers in pain research (Lausanne, Switzerland) · 2025Review
- Nociplastic Pain: A Critical Paradigm for Multidisciplinary Recognition and Management.Journal of clinical medicine · 2024Article
- Navigating Complexity in Postural Orthostatic Tachycardia Syndrome.Biomedicines · 2024Review
- Brain-heart interactions in fibromyalgia syndrome.Principles and practice of clinical research (2015) · 2024Article
- Vasodilatory Peripheral Response and Pain Levels following Radiofrequency Stressor Application in Women with Fibromyalgia.Biomedicines · 2024Article
- Chronic pain management in fibromyalgia: the INTEGRO (INTEGRated Psychotherapeutic InterventiOn) protocol and its application on two case studies.Frontiers in medicine · 2024Article
- The crosstalk of the pathophysiologic models in fibromyalgia.Clinical rheumatology · 2023Review
- Hypothetical framework for post-COVID 19 condition based on a fibromyalgia pathogenetic model.Clinical rheumatology · 2023Review
- Strong and aversive cold processing and pain facilitation in fibromyalgia patients relates to augmented thermal grill illusion.Scientific reports · 2023Article
- Psychoeducation for Fibromyalgia Syndrome: A Systematic Review of Emotional, Clinical and Functional Related-Outcomes.Behavioral sciences (Basel, Switzerland) · 2023Review
- Reply to 'Imbalance of threat and soothing systems in fibromyalgia: rephrasing an established mechanistic model?'Nature reviews. Rheumatology · 2023Article
- Central and peripheral mechanisms of pain in fibromyalgia: scoping review protocol.Rheumatology international · 2023Article
- Carbamazepine for Chronic Muscle Pain: A Retrospective Assessment of Indications, Side Effects, and Treatment Response.Brain sciences · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Several groups of investigators have described the presence of small fiber neuropathy in fibromyalgia patients. This writing discusses how this new finding could renovate fibromyalgia concept, diagnosis, and treatment. Predominant rheumatology thinking proposes fibromyalgia as a "centralized pain syndrome." An alternative hypothesis views fibromyalgia as a stress-related dysautonomia with neuropathic pain features. Dorsal root ganglia may be the key autonomic-nociceptive short-circuit sites. The recent recognition of small fiber neuropathy in a large subgroup of fibromyalgia patients reinforces the dysautonomia-neuropathic hypothesis and validates fibromyalgia pain. These new findings support fibromyalgia as a primarily neurological entity, nevertheless, rheumatologist will likely remain the best equipped specialist to diagnose fibromyalgia and differentiate it from other multi-symptomatic rheumatic syndromes. Skin biopsy and corneal confocal microscopy will probably become useful fibromyalgia diagnostic tests. Dorsal root ganglia sodium channel blockers are potential fibromyalgia analgesic medications. Subgroups of young girls with "autoimmune neuropathic fibromyalgia" may respond to immunoglobulin therapy. Multimodal intervention directed to regain autonomic nervous system resilience will likely remain the cornerstone for fibromyalgia therapy.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.