By: Lisa Martin
In a recent study of patients suffering from fibromyalgia, moderate to severe nerve damage was seen in their skin cells in nearly half of the patients.
The nerve damage to the nerve fibers has been considered small fiber polyneuropathy or SFPN. Small fiber polyneuropathy is caused by some specific diseases.
There is currently no known cause of fibromyalgia, so this nerve damage discovery could make some progress towards finding what exactly is causing the disorder.
Fibromyalgia disorders differ in patients from patient to patient, but typical symptoms include widespread chronic pain, extreme fatigue, and hypersensitivity to pain and pressure. The disorder affects women disproportionately compared to men.
consider nerve damage
Some advances have been made on how to properly diagnose the disorder, but its pathology still remains a mystery. Fibromyalgia shares some of the same symptoms as small-fiber polyneurotherapy, where small-fiber polyneurotherapy has resulted in widespread chronic pain in individuals diagnosed with it.
The study was conducted on 27 adults with the fibromyalgia disorder and a group of 30 healthy people who volunteered for the study. The same tests used in small-fiber polyneurotherapy diagnostics were used to test study participants. The tests included a physical examination and administration of a questionnaire.
In addition, the researchers administered skin biopsies to aid in evaluating the nerve fibers in the patient’s legs and monitoring the patient’s blood pressure, sweating and heart rate.
Neuropathy was found in very high numbers in fibromyalgia patients, while the healthy group appeared normal. Thirteen of the 27 fibromyalgia patients were recorded as having reduced nerve fiber density in their skin.
The thirteen or so individuals also had odd results on autonomic function tests. Based on these results, it was assumed that these thirteen subjects had small-fiber polyneurotherapy.
Although the conclusions drawn from this test do not suggest a cause for the development of all fibromyalgia conditions, they do give researchers some clues as to what causes fibromyalgia in some patients.
Fibromyalgia disorder is a very complicated, unique and complex disorder. Its symptoms and severity vary in each affected patient. Because of this unique differentiation, there is no single explanation for the development of fibromyalgia.
This process could take months or years before answers are found as to what the primary causes of fibromyalgia are. Before work can be done on a cure for fibromyalgia, researchers must first find out what exactly is causing the disorder in patients to develop.
This study is currently unique. The results were recently published, so other labs should soon start creating their own tests and experiments based on the draft of this study.
Some may have already started making some adjustments. The search for a better diagnosis of fibromyalgia is ongoing.
And finding better treatments for those individuals caused by the fibromyalgia disorder is one of the top priorities when it comes to this unique disorder.
Evidence of nerve damage in about half of fibromyalgia patients
Summary: About half of a small group of patients with fibromyalgia — a common syndrome that causes chronic pain and other symptoms — have had damage to nerve fibers in their skin and other signs of a condition called small fiber polyneuropathy (SFPN). . Unlike fibromyalgia, SFPN has a distinct pathology and is known to be caused by specific medical conditions, some of which can be treated and sometimes cured.
About half of a small group of patients with fibromyalgia — a common syndrome that causes chronic pain and other symptoms — have been found to have damage to the nerve fibers in their skin and other signs of a condition 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 certain medical conditions, some of which can be treated and sometimes cured. The study, by researchers at Massachusetts General Hospital (MGH), will appear in the journal PAIN and has been published online.
“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 in the search for better treatments,” said Anne Louise Oaklander, MD, PhD, director of the Nerve Injury Unit in the MGH Department of Neurology and corresponding author of the Pain paper.
The term fibromyalgia describes a set of symptoms — including chronic, widespread pain, increased tenderness, and fatigue — thought to affect 1 to 5 percent of people in Western countries, more commonly women. While a diagnosis of fibromyalgia has been recognized by the National Institutes of Health and the American College of Rheumatology, its biological basis has remained unknown. Fibromyalgia shares many symptoms with SFPN, a recognized cause of chronic, widespread pain for which there is objective testing.
To investigate the possible links between the two diseases, 27 adult patients with a diagnosis of fibromyalgia and 30 healthy volunteers were included in the current study. Participants underwent a series of tests to diagnose SFPN, including neuropathy based on a physical exam and responses to a questionnaire, skin biopsies to determine the number of nerve fibers in the lower legs, and tests of autonomic functions such as heart rate, blood pressure, and sweating.
Questionnaires, assessments of examinations, and skin biopsies revealed significant levels of neuropathy in the fibromyalgia patients but not in the control group. Of the 27 fibromyalgia patients, 13 had a marked decrease in nerve fiber density, abnormal autonomic function tests, or both, indicating the presence of SFPN. Participants who met criteria for SFPN were also screened for known causes of the condition, and although none of them had evidence of diabetes, a common cause of SFPN, two were found to have hepatitis C virus infection that can be successfully treated . and more than half had evidence of some type of immune system dysfunction.
“Up until now there hasn’t been a good idea of 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 independently confirming our results from other laboratories is already underway, and we also need to follow up those patients who do not meet SFPN criteria to see if we can find other causes. Helping one of those people get a definitive diagnosis and better treatment would be a great accomplishment. “
