Re: Are Peripheral Pain Generators Important in Fibromyalgia and Chronic Widespread Pain?

Abstract

Dear Dr. Gallagher, We appreciated Dr Gerwin's editorial [1] reflecting on the interesting Albrecht et al. study “Excessive peptidergic sensory innervation of cutaneous arteriole–venule shunts (AVS) in the palmar glabrous skin of fibromyalgia patients: Implications of wide-spread deep tissue pain and fatigue” [2]. Dr. Gerwin summarizes the findings by Albrecht et al. [2]—“that changes in blood flow and increased thermal sensitivity may each contribute to local palmar pain”—and asserts that thereby “they contribute to peripheral nerve sensitization which gives rise to local pain as well as contributing to central sensitization and central pain.” In the article we could not find the evidence for this assertion, which is notable for proclaiming that peripheral nerve sensitization is the fundamental “driver” of all possible somatic mechanisms of pain in this syndrome. Dr. Gerwin states, “It is the reduction …