Evidence of Nerve Damage in about Half of Fibromyalgia Patients

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Fibromyalgia has some of the same symptoms as small-fiber polyneurotherapy

There have been some advances made concerning how to properly diagnose the disorder, but its pathology still remains a mystery. Fibromyalgia has some of the same symptoms as small-fiber polyneurotherapy in that small-fiber polyneurotherapy has caused widespread chronic pain in the individuals that have been diagnosed with it.

In a recent study of patients suffering from fibromyalgia, nearly half of the patients were recorded as having moderate to severe nerve damage in their skin cells. The nerve damage done to the nerve fibers has been deemed small-fiber polyneuropathy, or SFPN. Small-fiber polyneuropathy is caused by a few specific medical conditions.

Currently, there is no known cause of fibromyalgia, so this nerve damage discovery could make some advances in the direction of finding what exactly causes the disorder. Fibromyalgia disorders differentiate patient to patient but the typical symptoms include widespread chronic pain, extreme fatigue, and hypersensitivity to pain and pressure. The disorder disproportionally affects women in comparison to men.

About half of a small group of patients with fibromyalgia a common syndrome that causes chronic pain and other symptoms was found to have damage to nerve fibers in their skin and other evidence of a disease called small-fiber polyneuropathy (SFPN).

Unlike fibromyalgia, which has had no known causes and few effective treatments, SFPN has a clear pathology and is known to be caused by specific medical conditions, some of which can be treated and sometimes cured. The study from Massachusetts General Hospital (MGH) researchers will appear in the journal PAIN and has been released online.

Pain is good because it alerts you that your body has sustained damage

Not all pains are equal. Typically pain is good because it alerts you that your body has sustained damage, prompting you to defend yourself against further destruction. Pain becomes chronic when a warning signal persists even after the threat is gone.

Fibromyalgia is one of many recognized forms of chronic pain. Most types of long-term pain are considered either inflammatory, as in some types of arthritis, or neuropathic, which often involves nerve damage. Part of the mystery of fibromyalgia is that its symptoms come from both categories, a fact that has only served to frustrate researchers, who have failed to find consistent evidence of either inflammation or damage.

“Instead of being in the brain, the pathology consists of excessive sensory nerve fibers around specialized blood vessel structures located in the palms of the hands,” said Dr. Rice, President of Intidyn and the senior researcher on the study. “This discovery provides concrete evidence of a fibromyalgia-specific pathology which can now be used for diagnosing the disease, and as a novel starting point for developing more effective therapeutics.”

“This provides some of the first objective evidence of a mechanism behind some cases of fibromyalgia, and identifying an underlying cause is the first step towards finding better treatments,” says Anne Louise Oaklander, MD, PhD, director of the Nerve Injury Unit in the MGH Department of Neurology and corresponding author of the Pain paper.

Fibromyalgia is too complex

“Until now, there has been no good idea about what causes fibromyalgia, but now we have evidence for some but not all patients. Fibromyalgia is too complex for a ‘one size fits all’ explanation,” says Oaklander, an associate professor of Neurology at Harvard Medical School.

“The next step of independent confirmation of our findings from other laboratories is already happening, and we also need to follow those patients who didn’t meet SFPN criteria to see if we can find other causes. Helping any of these people receives definitive diagnoses and better treatment would be a great accomplishment.”

Neuropathy was found in very high counts in the fibromyalgia patients

The study was conducted on 27 adults with the fibromyalgia disorder and a group of 30 healthy individuals that had volunteered for the study. The same tests that are used in the diagnoses of small-fiber polyneurotherapy were used to test the participants of the study.

The tests included a physical examination and administration of a questionnaire. Additionally, the researches administered skin biopsies the help with the evaluation of nerve fibers in the patients’ legs and the monitoring of blood pressure, sweating, and the patients’ heart rates.

Neuropathy was found in very high counts in the fibromyalgia patients, while the group of healthy individuals seemed normal. Thirteen of the 27 fibromyalgia patients were recorded as individuals with reduced levels of nerve fibers density in their skin. Those some thirteen individuals also had odd autonomic function test results. Because of these results, it was presumed that these thirteen individuals had small-fiber polyneurotherapy.

While the conclusions drawn from this test does not suggest a cause in the development of all fibromyalgia conditions, it does give researchers some evidence as to what causes fibromyalgia in at least some patients. The fibromyalgia disorder is very intricate, unique, and complex disorder. Its symptoms and severity are different in each patient that it affects.

Because of this unique differentiation, there is no one explanation for the development of fibromyalgia. This process could take months or years before answers are found as to what are the primary causes of fibromyalgia. Before work on a cure of fibromyalgia can be done, researchers must first find what exactly causes the disorder to develop in patients. This study is currently the one of its kind.

The results have recently been published so other laboratories should soon begin creating their own tests and experiments according to the blueprint this study has constructed. Some may have already started with a few adaptations. The search for a better diagnosis of fibromyalgia is an ongoing one. And finding better treatments for those individuals that have been inflicted by the fibromyalgia disorder is one of the top priorities when it comes to this unique disorder.


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Study Reference:

  • Evidence of nerve damage in about half of fibromyalgia patients Source:Massachusetts General Hospital via Science Daily

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