By: Dr Alex Robber
Fibromyalgia has some of the same effects as polyneurotherapy with small fibers
Some advances have been made regarding how to properly diagnose the disorder, but its pathology is still a mystery. Fibromyalgia has some of the same effects as small-fibre polyneurotherapy except that small-fiber polyneurotherapy has induced widespread chronic pain in the diagnosed individuals.
Nearly half of patients were confirmed to have mild to serious nerve damage in their skin cells in a recent study of patients suffering from fibromyalgia. The nerve damage caused to the nerve fibers was called polyneuropathy with small fibers, or SFPN. A few different medical conditions cause small-fiber polyneuropathy.
There is currently no clear cause of fibromyalgia and this discovery of nerve damage may make some steps in discovering out what causes the condition. Fibromyalgia conditions vary patient by patient, but the main signs include severe chronic pain, intense weakness and pain and pressure hypersensitivity. The disease affects women significantly, relative to men.
Approximately half of a small group of patients with fibromyalgia, a common condition that causes chronic pain and other symptoms, has been found to damage their skin’s nerve fibers, as well as other evidence of a disorder called polyneuropathy with small fibres.
Unlike fibromyalgia, which had no known causes and few effective treatments, SFPN has a clear pathology, and it is known to be caused by specific medical conditions, some of which can be treated and sometimes cured. The analysis by researchers at the Massachusetts General Hospital (MGH) will appear in the PAIN journal and has been published online.
Pain is good because it alerts you that your body has sustained damage
Not all pain is equal. Usually pain is good as it warns you your body has suffered damage, allowing you to protect yourself from further harm. Pain is persistent long after the danger is gone, when an alert signal remains.
Fibromyalgia is one of the types of chronic pain which is recognized. Some forms of long-term pain are either considered chronic, as with some cases of arthritis, or neuropathic, often causing nerve damage. Part of the mystery of fibromyalgia is that its symptoms come from both types, a fact that has only served to frustrate researchers, who have not found clear proof of either inflammation or injury.
“Instead of being in the brain, the pathology consists of excessive sensory nerve fibers situated in the palms of the hands around complex blood vessel structures,” Dr. Rice, Intidyn’s president and senior researcher on the study said. “This finding offers clear proof of a condition unique to fibromyalgia that can now be used to treat the disorder, and as a new starting point for creating more successful therapies.”
“This provides some of the first objective evidence of a mechanism behind some cases of fibromyalgia, and the first step towards finding better treatments is to identify an underlying cause,” says Anne Louise Oaklander, MD, PhD, director of the Nerve Injury Unit at the MGH Department of Neurology and corresponding author of the Pain paper.
Fibromyalgia is too complex
“There has not been a clear understanding so far on what causes fibromyalgia, but now we have evidence for certain patients but not all. Fibromyalgia is too difficult to describe’ one size fits all’, “says Oaklander, a Harvard Medical School associate professor of neurology.
“The next move is already taking place to independently validate our results from other labs, and we will need to monitor those patients that have not met SFPN guidelines to see whether we can identify other reasons. It would be a great accomplishment to help some of these people get clear diagnosis, and better care.
Neuropathy was found in very high counts in the fibromyalgia patients
The study was carried out on 27 individuals with fibromyalgia disorder and a total of 30 healthy people who had volunteered for the research. The same methods used in small-fiber polyneurotherapy diagnosis were used to assess the study participants.
The tests included physical examination and questionnaire administration. The researchers also administered skin biopsies to help assess nerve fibers in the legs of patients and monitor blood pressure, sweating, and heart rates of patients.
In the patients with fibromyalgia, neuropathy was found in very high counts, while the group of healthy individuals seemed average. Of the 27 patients with fibromyalgia, 13 were identified as individuals with decreased levels of density of nerve fibers in their bodies. Those few thirteen individuals have had odd test results for autonomic control. Because of these findings, those thirteen individuals were believed to have small fiber polyneurotherapy.
Although the findings drawn from this study do not indicate a cause in the development of all cases of fibromyalgia, it does offer some evidence to researchers as to what causes fibromyalgia in at least some patients. The condition with fibromyalgia is very complicated, special and complex. In every condition it affects, the symptoms and severity are different.
There is no explanation for the development of fibromyalgia, because of this unique differentiation. This process might take months or years to find answers as to what are the main causes of fibromyalgia. Until work can be performed on a treatment for fibromyalgia, researchers first have to figure out what actually causes people to develop the condition. The research is the one of its kind at the moment.
Recently the findings have been released, so that other laboratories can soon start designing their own studies and experiments according to the model that this study has created. Some may already have begun with some adaptations. The quest for a more successful treatment of fibromyalgia is continuing. So, finding new therapies for all individuals afflicted with the fibromyalgia condition is one of the top priorities for this particular disease.
- Evidence of nerve damage in about half of fibromyalgia patients
- Source: Massachusetts General Hospital via Science Daily