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Attitudes toward pain and methods of dealing
with pain patients are indicators of both
the state of a society and the capability and
competitiveness of sociocultural and socioeconomic
systems. Despite all of the enormous
technological advances in recent decades, we
are still unable to objectively understand all
of the dimensions of individual pain. Looking
at pain from a purely scientific perspective will
enable a partial approach, only. Thus pain joins
the series of human manners of existence and
experience, which, obviously, are beyond an
exclusively rational analysis and control. A dignified
way of dealing with such “transcendental”
manners of existence and experience guarantees
the survival of human society.
The results of the previous “Les Entretiens du
Carla” meetings typified fibromyalgia as a “prototype” of such pain diseases. It was a logical
progression, when after “From Complaints to
Evidence” (clinical significance, epidemiological
data, evaluation of clinical outcome
measurements, and subgrouping), and after “About Mechanisms” (nociceptive input, temporal
summation, central sensitization, neuroimaging, distress, genetics, and potential drug actions), a “Multidisciplinary Support” was considered and
discussed. This year, a patient and a representative
of a patients’ association were among the
participants. Different perspectives and different
approaches toward fibromyalgia were
emphasized even more than during the previous “Entretiens.” Thus the heterogeneity of the
disease, itself, has been highlighted. Difficulties
in validating exercise treatment have to be
considered thoroughly. Alternative medicine
approaches were not discussed in detail. They are
widely used, but not evidence based (lack of RCTs).
A multidisciplinary approach, supporting
pharmacological treatment, will have to take into
account several conditions and will include
different modalities. This leads to redundance,
inevitably. We decided not to remove redundance
from “conclusions and recommendations” of the
respective topics. To keep the discussion ongoing,
rather, we report redundance as a result. The
articles elucidate that the therapy for fibromyalgia
is still not available, that different approaches are
and will be possible. They encourage initiation of
new research projects.
Following the tradition of the recent years,
the results of the “Entretiens” will be presented
as a symposium at the annual EULAR congress.
We are firmly convinced that the 2006 symposium
will arouse new discussions, stimulate exciting
conversations, and initiate new research ideas. In
this sense, all participants and “Pierre Fabre
Laboratories” deserve many thanks.
From left to right
and top to bottom:
Fabien Pillard,
Yves Mainguy,
Étienne André,
François Brackman,
Daniel Rivière,
Richard Gracely,
Olivier Vitton,
Dominique Crouzit,
Guy Lemichel,
Claude Schmitt,
Isabelle Picaud,
Piercarlo Sarzi Puttini,
Viviana Tavares,
Thierry Ginolhac,
Karl Henriksson,
Francis Blotman,
Jordi Carbonell,
Jackie Brunet,
Michael Späth,
Florence Gaudoux,
Maria Elisa Domingues,
Vera Lemgruber,
Jorge Alberto Costa e Silva,
Christine Cedraschi,
Marcel-Francis Kahn,
Jaime Branco,
Dan Buskila,
Chris Henriksson,
Jean-Pierre Marcantoni |
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