Doctors, researchers and patients are eager for advancements in the field of fibromyalgia research. Without a cause identified, no standard treatment method can be determined. Theories have been developed concerning fibromyalgia cause, the most popular of which is the central sensitization theory. According to this theory, a disruption either in the brain’s processing of nerve signals or in nerve signaling itself results in the constant perception of pain, even though no painful stimuli are present.
A new theory has emerged in 2013, one that may fit into the old or strike out on a new path. The theory is founded on a study with a very small sample size yielding very big results. Researchers collected skin biopsies from the palms of fibromyoalgia patients and healthy controls. Using microscopic technology, they analyzed the skin and found a drastic difference between the two groups: Fibromaylgia patients’ skin had a far greater number of vasodilatory sensory nerves than the healthy skin samples. In order to understand what this means, let’s start with a little glossary of terms.
Arteriole: A small artery. Blood passes from arteries to arterioles, and then onto smaller capillaries and into the tissues of the body.
Venule: A small vein. Blood travels from the capillaries into venules, then back to larger veins on its way home.
AV Shunt: A valve between the arteriole and venule. When the valve is closed, blood travels from the arteriole into the capillary, then into the venule. When the valve opens, it interrupts the flow of blood into capillaries, diverting it into the venule instead.
Vasodilatory Sensory Nerves: These nerves are responsible for both sensation and opening the AV shunt, preventing blood from entering capillaries.
Researchers found that fibromyalgia patients had a significantly greater number of vasodilatory sensory nerves, meaning that blood was not being carried all the way to capillaries and the various tissues of the body. What would this have to do with fibromyalgia symptoms?
There are two ways in which this abnormality could explain fibromyalgia. First, an increase in the number of sensory nerves could explain an increase in the sensation of pain; one of the hallmarks of fibromyalgia is tenderness at certain points in the body.
Second, a lack of proper blood supply could explain the muscle pain and fatigue fibromyalgia patients experience. Blood carries nutrients and oxygen to muscles; it also carries waste products away. If normal blood flow isn’t supplied to the muscles due to open AV shunts, then 1) they aren’t receiving the nutrients and oxygen they need to perform work, and 2) waste products aren’t being flushed away. For a long time, a buildup of lactic acid (waste) in muscles was believed to cause soreness, but this has been contested by a notable amount of research. But receiving inadequate nutrients and oxygen could definitely cause muscle pain and fatigue. When muscles are malnourished, they tend to tense up to protect themselves from use. This causes pain and, potentially, spasms.
What can we take away from this study? There’s good news and bad news; let’s go with the bad first. Much more research needs to be done to 1) confirm the results of this small but important study, and 2) then, a bunch more research needs to be done to test for effective treatment methods if this is in fact a fundamental component of fibromyalgia.
The good news is that every new research study into fibromyalgia that finds a possible answer is a breath of hope for patients. Research also helps to quell the still-present perception that fibromyalgia is “all in your head.” Science is moving closer to understanding fibromyalgia. Every step toward an answer is a step toward developing effective fibromyalgia treatment.
For more information on this study and the theory it proposes, see www.intidyn.com.