Fibromyalgia is not all in your heads, new research confirms

Fibromyalgia (FM) is a commonly misjudged condition that causes widespread pain and fatigue. If you’ve been diagnosed with FM and are trying to learn all you can about the condition, you may come across some myths and misunderstandings about FM. The topmost misconception is that people consider FM is not an actual medical problem or that it is “all in your head.”

There’s a lot that’s unknown and unidentified about FM, but researchers have learned more about it in just the past few years. In people who have FM, the brain and spinal cord process pain signals in a different way. As a result, they respond more intensely to touch and pressure, with an amplified sensitivity to pain. It is an actual physiological and neurochemical problem.

In our society, people incline to think that there is a cure or a fix for every medical problem. You go to the physician, expecting he or she will fix whatever is wrong with you with medication or surgical treatment. It is annoying to people with FM because the customary treatment methods is not effective. And it is also frustrating to health care workers because they want to help people. But there is no easy fix. It takes lifestyle variations and small steps toward accomplishing wellness. It is a process.

More people comprehend that FM is an actual problem, often because they know someone who has it, possibly a sister or daughter or mother. And more men are being diagnosed with FM now that the diagnostic standards are no longer fixated so heavily on the number of tender points you might have.

Now, an advance discovery by scientists at Integrated Tissue Dynamics LLC (Intidyn) has provided a biological logic for this mysterious disease. The company, founded by neuroscientists Dr. Frank L. Rice and Dr. Phillip J. Albrecht, used an exclusive multi-molecular ChemoMorphometric Analysis (CMA) to assess nerve fibers within small skin biopsies. The study was limited to women who are more than twice as expected to be afflicted by fibromyalgia as men.

“We detected extremely excessive sensory nerve fibers around blood vessels in the palms of the hands,” said Dr. Rice. “This discovery delivers tangible proof of a FM specific pathology that is evidently outside of the brain.  This could be used to facilitate the diagnosis of the disease and provide a new target for the development of truly effective therapeutics.”

Nerve Endings Come In Many Forms

3 years ago, Intidyn scientists published the discovery of an unidentified nervous system function among the blood vessels in the skin in the journal PAIN. As Dr. Rice explained, “we examined the skin of a mostly interesting patient who lacked all the numerous varieties of sensory nerve endings in the skin that supposedly accounted for our highly sensitive and richly nuanced sense of touch. Interestingly however, this patient had surprisingly normal function in everyday chores.

But, the only sensory endings we detected in his skin were those around the blood vessels”. Dr. Rice continued, “We previously thought that these nerve endings were only involved in regulating blood flow at a subconscious level, yet here we had proof that the blood vessel endings could also contribute to our conscious sense of touch… and also pain.” “Knowing how these drugs were supposed to work on molecules in the brain,” Dr. Albrecht added, “we had proof that similar molecules were involved in the function of nerve endings on the blood vessels. Therefore, we hypothesized that FM might involve a pathology in that location”. As the results prove, they were correct.

A Thermostat for the Skin

Notably, the excessive nerve fibers were concentrated around tiny muscular valves, called arteriole-venule (AV) shunts.  In humans, these shunts are found in the palms of our hands and soles of our feet and work like the radiator in a car.

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In warm conditions, the shunts close, which forces blood into the capillaries at the skin surface to radiate heat from the body. Under cold conditions, the shunts open allowing blood to go around the capillaries to conserve heat, which is why our hands get cold. According to Dr. Albrecht, “the excess sensory innervation may clarify why FM patients usually have particularly tender and painful hands.”

A role in regulating blood flow throughout the body.

Although they are typically restricted to the hands and feet, the shunts likely have another vital function which could account for the widespread achiness, deep pain, and exhaustion that occurs in FM patients. Noticing that blood flow to the hands is usually known to be diverted to muscles during exercise, Dr. Rice suggests that “That mismanaged blood flow due to malfunctioning shunts could also interfere with blood flow to the muscles throughout the body. This could be the source of wide spread muscular pain, achiness and fatigue which are thought to be due to a build-up of lactic acid and low levels of swelling FM patients.

This, in turn, could contribute to the hyperactivity in the brain.” Dr. Albrecht also points out that changes of normal blood flow may underlie other FM symptoms, such as non-restful sleep or cognitive dysfunctions. “The data do seem to fit with other published proof indicating blood flow changes to higher brain centers and the cerebral cortex of FM patients” he stated.

Senior Research Chair of the Alan Edwards Center for Pain Research at McGill University, Dr. Gary Bennett, remarked after seeing the results that “It is sensational that something has finally been found. We can hope that this new discovery will lead to new treatments for FM patients who now receive little or no relief from any medicine.” This discovery of a distinct tissue pathology determines that FM is not “all in your head”, which should offer a massive relief to fibromyalgia patients, while altering the clinical belief of the disease and managing future methods for successful treatments. If people with FM believe there is no help or support for them, they are going to stay untreated.

Even if there is not a cure, there are treatments that can actually improve their quality of life. They need to know that it is OK to ask for help with things, and that it is OK to give themselves time for exercise and relaxation each and every day. They need to make their own health a priority.

Reference: via Medical Xpress More information: Albrecht PJ, Hou Q, Argoff CE, Storey JR, Wymer JP, Rice FL (2013). Excessive Peptidergic Sensory Innervation of Cutaneous Arteriole-Venule Shunts (AVS) in the Palmar Glabrous Skin of Fibromyalgia Patients: Implications for Widespread Deep Tissue Pain and Fatigue. Pain Medicine, May 20. doi: 10.1111/pme.12139 [Epub ahead of print].

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