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ARTHRITIS & RHEUMATISM
Vol. 43, No. 3, March 2000, pp 708–709
© 2000, American College of Rheumatology
CONCISE COMMUNICATION
Fibromyalgia in Frida Kahlo’s life and art
The great Mexican painter Frida Kahlo (1907–1954) is
without doubt one of the most intense and emotive artists of the
twentieth century. Frida’s life changed dramatically at the age of
18, when she was involved in a terrible accident. A streetcar
violently impacted the bus in which she was riding. She suffered
multiple bone fractures, including the third and fourth lumbar
vertebrae, and had a deep abdominal wound inflicted by a metal
rod. She was confined for several months in a plaster corset. From
that time on, Frida suffered severe, widespread pain and pro-
found fatigue. Generalized pain and exhaustion lingered with her
for the remainder of her life (1–5).
Through the years, a variety of diagnoses were offered
to explain her chronic illness, such as tuberculosis and syphilis,
that were later ruled out. She received diverse types of
treatments, including medications and long periods of confine-
ment in a metal or plaster corset. In efforts to relieve her pain,
she underwent several orthopedic operations on her spine,
both in Mexico and in the United States, without improvement
in her symptoms.
Despite her debilitating illness, Frida was engaged in
an active social life. She had a tempestuous marriage to the
famous Mexican muralist Diego Rivera. She traveled exten-
sively and had relationships with the world leaders and artistic
personalities of her time. Frida began painting after her
accident. During periods of immobilization in a plaster corset,
she used a special easel, and a mirror was attached to the
canopy of her bed so that she could focus on herself. Although
her painting skills were largely self-taught, she was also ac-
quainted with the traditional schools of painting. Both in her
oeuvre and in her customs, she looked back with devotion to
her Mexican roots. The Surrealists claimed her as one of their
own. The stillness of her self-portraits reflects the influence of
her father, who was a photographer (3).
Frida used to describe her own paintings as “the most
frank expression of myself” (1). Her self-portraits are impas-
sioned. Anguish and pain are the common themes of her work.
These emotions are dramatically expressed in her oil painting,
“The Broken Column” (Figure 1). As Hayden Herrera ob-
served, Frida’s determined impassivity creates an almost un-
bearable tension. Pain is made vivid by nails driven into her
naked body. A gap resembling an earthquake fissure splits her
torso. The opened body suggests surgery. Inside her torso, we
see a cracked ionic column. The corset’s white straps accentu-
ate her beautiful body. Her hips are wrapped in a cloth
suggestive of Christian martyrdom. She stares straight ahead
with dignity. Tears dot her cheeks, but her features refuse to
cry. An immense and barren plain in the background conveys
physical and emotional suffering (1).
To explain Frida’s chronic illness, we offer an alterna-
tive diagnosis. Our opinion is that she suffered posttraumatic
fibromyalgia. This prevalent syndrome is characterized by
persistent widespread pain, chronic fatigue, sleep disorders,
and vegetative symptoms, and by the presence of tender points
in well-defined anatomic areas (6,7). The concept of fibromy-
algia as a clinical entity as we know it today was probably
unknown to most physicians of the early twentieth century.
Our diagnosis explains her chronic, severe, widespread pain
accompanied by profound fatigue. It also explains the lack of
response to diverse forms of treatment. The onset of fibromy-
algia after physical trauma is well-recognized (8).
A drawing in Frida’s diary reinforces our diagnostic
impression (9). She depicts herself in pain, and 11 arrows point
to anatomic sites that are near the conventional fibromyalgia
tender points (6). Of course, because fibromyalgia is an illness
without anatomic sequelae, our contention cannot be proven
or disproven. What appears certain is that Frida’s self-portraits
convey widespread pain and anguish with the emotional over-
tones that fibromyalgia patients frequently use to describe
their illness.
We are indebted to Dr. Leonardo Zamudio, who allowed us to
have access to Frida Kahlo’s medical records, to Ms Dolores Olmedo,
who gave permission to reproduce “The Broken Column,” and to Dr.
Robert Kalish, who kindly reviewed the manuscript.
Figure 1. The Broken Column (1944), oil painting on masonite, 42 ⫻
33 cm. Reproduced, with permission, from the Museum Dolores
Olmedo Patin˜o in Mexico City.
708
Manuel Martı´nez-Lavı´n , MD
Mary-Carmen Amigo, MD
Javier Coindreau, MD
Instituto Nacional de Cardiologı´a Ignacio Cha´vez
Mexico City, Mexico
Juan Canoso, MD
American British Cowdray Hospital
Mexico City, Mexico
1. Herrera H. Frida: a biography of Frida Kahlo. New York: Harper
Row; 1983.
2. Tibol R. Frida Kahlo: una vida abierta. Mexico City: Universidad
Nacional Auto´noma de Me´xico; 1998.
3. Zamora M. Frida Kahlo: the brush of anguish. San Francisco:
Chronicle Books; 1990.
4. Monsiva´is C. Vazquez-Bayod R. Frida Kahlo: una vida, una obra.
Mexico City: Conaculta; 1992.
5. Del Conde T. Frida Kahlo: la pintora y el mito. Mexico City:
Universidad Nacional Auto´noma de Me´xico; 1992.
6. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C,
Goldenberg DL, et al. The American College of Rheumatology
1990 criteria for the classification of fibromyalgia: report of the
multicenter criteria committee. Arthritis Rheum 1990;33:160–
72.
7. Martı´nez-Lavı´n M, Hermosillo AG, Rosas M, Soto M-E. Circa-
dian studies of autonomic nervous balance in patients with fibro-
myalgia: a heart rate variability analysis. Arthritis Rheum 1998;41:
1966–71.
8. Buskila D, Neumann L, Vaisberg G, Alkalay D, Wolfe F. In-
creased rate of fibromyalgia following cervical spine injury: a
controlled study of 161 cases of traumatic injury. Arthritis Rheum
1997;40:446–52.
9. Freeman P. Frida Kahlo: Diario: autorretrato ı´ntimo. Mexico City:
La Vaca Independiente; 1995.
Clinical Images: Tuberculous arthritis
The patient, a 62-year-old woman, presented to our hospital with pain in the right foot, which had started 1 year previously and had
increased constantly until she was unable to walk on the foot. Physical examination revealed swelling and erythema of the middle
area of the right foot. The white blood cell count was 9,000/
l, with 76% neutrophils. The C-reactive protein level was 2.3 mg/dl.
Sagittal magnetic resonance imaging (T1-weighted, fat-suppressed, spin-echo) with contrast medium showed massive uptake of
contrast medium in the navicular, cuboid, and cuneiform bones, with subchondral destruction consistent with inflammation (A).
Aspiration of the cuneonavicular joint was performed. Synovial analysis showed an increased white cell count (41,000/
l; 20%
lymphocytes). Microscopic examination with Ziehl-Neelsen staining revealed acid-fast bacilli (B). Polymerase chain reaction and
culture demonstrated Mycobacterium tuberculosis. Tuberculous arthritis was diagnosed, and the patient began treatment with
quadruple tuberculostatic therapy (isoniazid, rifampin, ethambutol, pyrazinamide). Symptoms resolved slowly.
Rika Draenert, MD
Herbert Kellner, MD
Medizinische Poliklinik
Ludwigs-Maximilians-Universita¨t
Munich, Germany
CONCISE COMMUNICATIONS 709
