The Role of Fibromyalgia in Rheumatology

No-supplastic at least does suggest that it's modifiable or adaptable. So can you help us understand how those new categories interplay with the concept of top-down and bottom-up frameworks of understanding pain particularly in rheumatology? Yeah so a long time ago we used to delineate fibromyalgia into primary fibromyalgia which was individuals with just fibromyalgia plus some irritable bowel and headache but no identifiable autoimmune disease for example. We would use the term secondary fibromyalgia for individuals with rheumatoid arthritis or lupus or osteoarthritis or sickle cell disease who started out as having a peripheral pain syndrome over time developed this sort