Rational Biological Source of FM Pain in Skin
As anyone who has fibromyalgia knows, the widespread deep pain and fatigue can be very debilitating. There are indications that the source of pain and fatigue is due to hypersensitivity of nerve cells within the central nervous system (called central sensitization), but why this may be occurring is unknown. Otherwise, no specific pathology has been identified that could be the source of the problem, which in itself can fuel self doubts.
A research team headed by neurologists Charles Argoff, MD and James Wymer, MD, PhD and James Storey, MD (who performed the clinical assessments) and neuroscientists Phillip Albrecht, PhD, Auanzhi Hous, MD, PhD and Frank Rice, PhD (who analyzed the nerve endings in the skin in patients with fibromyalgia). The unique expertise of this team along with microscopic technology to examine small skin biopsies collected from the palms of fibromyalgia patients were used to analyze nerve endings. The FM patients in this study were limited to women and were diagnosed and treated by Drs. Argoff, Wymer and Storey. The skin biopsies were about one-half the size of a pencil eraser.
In this study, the research team uncovered an inordinate increase in sensory nerve fibers at specific sites within the blood vessels of the skin in the palms of the hands. These critical sites are tiny muscular valves, called arteriole-venule (AV) shunts, which form a direct connection between arterioles and venules. The discovered pathology involving the nerve endings to the shunts provides a logical explanation not only for extreme tenderness in the hands, but also for the widespread deep pain and fatigue symptomatic of fibromyalgia. The relevance of these findings includes problems with the body's cooling and heating system, which is theorized to play a role in fibromyalgia symptoms.
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(http://www.intidyn.com/Newsroom/article-0009.html)
(Published in the June 2013 Issue of the Journal of Pain Medicine)