Fibromyalgia is a poorly understood disorder that is characterized by joint pain, deep tissue pain, fatigue, depression, headaches, depression and lack of sleep. It affects about 10 million Americans, and one in 20 people worldwide. The underlying cause of fibromyalgia has confounded physicians for decades. To analyze the nerve endings, Rice and his colleagues used microscopic technology to study small skin biopsies collected from the palms of fibromyalgia patients. The study was limited to women, who have over twice the occurrence of fibromyalgia than men. The team found the extra sensory nerve fibers in tiny muscular valves or “shunts,” which form a direct connection between arterioles and venules, the blood vessels in the skin. The shunts essentially act as thermostats, regulating body heat. Under warm conditions, the shunts close down to force blood into the capillaries of the skin in order to radiate heat away from the body. Under cold conditions, the shunts open wide, allowing blood to bypass the capillaries in order to conserve heat. “The excess sensory innervation may itself explain why fibromyalgia patients typically have especially tender and painful hands. But, in addition, since the sensory fibers are responsible for opening the shunts, they would become particularly active under cold conditions, which are generally very bothersome to fibromyalgia patients,” said Dr. Charles Argoff, an Albany Medical Center neurologist and pain specialist, who was the study’s primary investigator. Although they are mostly limited to the hands and feet, researchers say the shunts could have another important function which could account for the widespread pain, achiness, and fatigue that occurs in fibromyalgia patients. “An enormous proportion of our blood flow normally goes to our hands and feet. Far more than is needed for their metabolism” noted Dr. Rice. “As such, the hands and the feet act as a reservoir from which blood flow can be diverted to other tissues of the body, such as muscles when we begin to exercise. Therefore, the pathology discovered among these shunts in the hands could be interfering with blood flow to the muscles throughout the body. This mismanaged blood flow could be the source of muscular pain and achiness, and the sense of fatigue which are thought to be due to a build-up of lactic acid and low levels of inflammation (in) fibromyalgia patients.” “It is exciting that something has finally been found.” said Dr. Gary Bennett, Senior Research Chair of the Alan Edwards Center for Pain Research at McGill University. “We can hope that this new finding will lead to new treatments for fibromyalgia patients who now receive little or no relief from any medicine.”
Posted on: Thu, 20 Jun 2013 06:58:22 +0000
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