Physical Cause of Fibromyalgia

New research literally places the cause of fibromyalgia in the palm of your hand. It's welcome news for those who suffer from the condition, who cannot find relief from body aches and fatigue and are often told by doctors that the pain is all in their heads.

Until now, little was known about the ailment, which causes deep tissue pain, especially in the hands and feet. Sufferers also report difficulty sleeping and trouble thinking clearly. There has been no way to confirm the existence of the disease in patients, other than using brain imaging scans, which sometimes show gray matter loss and an increase in the pain response known as "central sensitization."

In a study published in this month's issue of Pain Medicine, scientists at Integrated Tissue Dynamics (Intidyn) in New York report that the cause of fibromyalgia is actually an abnormality in the palms of patients' hands.

A team led by Dr. Frank Rice, a neuroscientist and president of Intidyn, as well as pain specialist Dr. Charles Argoff, a neurologist at Albany Medical Center in New York, found an enormous increase in the number of sensory nerve fibers within the blood vessels of the skin on the palms of fibromyalgia patients' hands.

Rice told Healthline the next step is to find out why there are so many of these nerve fibers. “We have ways to do that, and once we go in and figure that out, it will raise the question of how to treat this,” he said. “We now know where to look and we know what's wrong. Now we need to figure out why it went wrong.”

The discovery also reveals clues to the cause of other fibromyalgia symptoms. In the hands and feet, the blood vessels act as shunts, helping to speed blood flow and regulate body temperature.

The shunts act like a radiator in a car, Rice said, shutting down in warm conditions to radiate heat and opening up when it gets cold. The increased activity of the fibers in cold weather explains why fibromyalgia sufferers experience more pain during chilly times.

The extremities also act as reservoirs, storing blood for when the body needs it, such as during exercise. So, problems with blood vessels in the hands also interfere with blood flow throughout the body, Rice said, perhaps explaining why fibromyalgia patients feel pain in various muscle groups. A decrease in blood flow from the hands may also trigger fatigue.

Argoff said the discovery will likely lead to better treatments and less confusion for fibromyalgia patients. “Typically, a person with fibromyalgia may see more than 10 healthcare providers, including multiple specialists, before being properly diagnosed,” Argoff told Healthline. “Who wouldn't be frustrated under those circumstances?”

The study, funded by pharmaceutical companies Forest Laboratories and Eli Lilly, included only female subjects. Women are diagnosed with fibromyalgia twice as often as men.

The condition can currently be treated by three medications made by Forest and Eli Lilly: Cymbalta, Lyrica, and Savella. Rice said the companies are currently developing new prescription drugs for fibromyalgia, but did not give a timetable for their release, citing proprietary information.

Argoff said many healthcare providers in the U.S. don't believe fibromyalgia exists, despite the availability of diagnostic criteria. He said some doctors label patients who complain of the symptoms as “malingerers” or “hysterical.”

Tara Manley of San Diego, Calif., has been managing her fibromyalgia for five years. She told Healthline she had a hard time convincing doctors that she was in pain. “Everything came back wonderful from all the tests, and I looked healthy,” she said.

However, there were times when the pain became so unbearable that she ended up in a wheelchair. Finally, a doctor in Los Angeles, who also suffers from fibromyalgia, diagnosed her, she said.

Sue Shipe, who lives in an Albany, New York, suburb, also has fibromyalgia. She founded the Institute for Human Empowerment in 2000 to advocate for people with the condition. She has successfully lobbied the state of New York to pass annual resolutions recognizing the illness.

She told Healthline that finding a physical cause for the condition is big news. “It validates the patient's experience," Shipe said.

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