Abstract
In a brief report in this issue of Pain Medicine , Drs Thimineur and De Ridder present interesting results from a group of 12 patients with fibromyalgia (FM) that underwent implantation of neurostimulation devices in the occipital region, primarily to treat their chronic headaches, but experienced improvement in their diffuse pain, fatigue, and overall well-being [1]. The results are indeed quite impressive as the improvement was statistically significant pretty much in every parameter, and persisted for 6 months in each operated patient. In my opinion, the main conclusion of this report is that we still have very little understanding on what happens in patients with FM. Does headache facilitate development of body pain to such degree that headache relief results in improvement of diffuse pain and other FM symptoms? Does neurostimulation suppress some nociceptive pathways (or stimulate inhibitory pathways) that are involved in FM pain generation? Are there any novel (and possibly unique) mechanisms of action that allow very low frequency stimulation, that …
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