Researchers have discovered a potential biological basis for fibromyalgia in patients' skin. Current treatment uses medications that act solely within the brain. It brings varying degrees of relief.
Scientists at Integrated Tissue Dynamics LLD (Intidyn) reported their findings in the journal Pain Medicine. Their work was part of an Albany Medical College study on fibromyalgia. The researchers found a unique pathology in the skin of female patients, one they believe could be the biological basis of the mysterious condition, says Medical News Today.
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), fibromyalgia symptoms can include muscle pain, fatigue, difficulty sleeping, headaches, painful menstrual periods, stiffness in the morning, numbness or tingling in the hands or feet, and cognitive problems sometimes referred to as "fibro fog." The disorder affects around 10 million Americans who are at least 18. Eighty to 90 percent are women, NIAMS says. The Intidyn study included only subjects who were women.
The Mayo Clinic reports that the primary medications prescribed are analgesics, anti-seizure drugs, and antidepressants. Medical providers often encourage patients to make lifestyle changes to reduce stress, get regular exercise, get enough sleep, eat and drink healthy foods and beverages, and pace themselves as far as energy level goes. Some patients use alternative therapies like yoga, acupuncture, tai chi, and massage therapy to manage pain and stress.
Based on earlier work, the Intidyn team knew that current drugs were designed to work on molecules found in the brain and that similar molecules had a role in how nerve endings on blood vessels work. The research confirmed their hypothesis that fibromyalgia could be based on a pathology involving blood vessels.
Using a special microscope, they studied skin biopsies from the palms of their fibromyalgia subjects. They noted a big jump in sensory nerve fibers at certain sites that are small muscular valves in the skin's blood vessels. The valves are called arteriole-venule (AV) shunts and occur only in the palms of the hands and the soles of the feet.
In the hand, they play a role in regulating body temperature, opening to permit blood to bypass capillaries and save heat and causing the hands to get cold. Under cold conditions, the shunts become especially active, perhaps a reason why the cold bothers fibromyalgia patients so much. The pathology the scientists discovered among the AV shunts and the resulting alteration of blood flow could also be the source of achiness, muscle pain, poor sleep, and cognitive issues linked to the disorder.
The discovery of a potential biological basis for fibromyalgia should bring emotional relief to patients who were once told the disorder was "all in the head." It's a starting point for the eventual development of new types of treatment and an opportunity for some individuals to get significant relief for the first time.
Vonda J. Sines has published thousands of print and online health and medical articles. She specializes in diseases and other conditions that affect the quality of life.
- Disease & Medical Conditions