End Fatigue

Nerve Changes are Seen in the Skin of People with Fibromyalgia

Here is another new study showing nerve changes in peripheral nerves of FMS patients, which may also contribute to pain.

This, in association with our earlier reported study showing the high frequency of neuropathic changes, makes it very likely that we are dealing with nerve pain in addition to muscle pain. This explains part of the effectiveness of medications that stabilize nerve function (e.g. neurontin, lyrica, etc) in Fibromyalgia in addition to their treating central sensitization (pain stemming from "sensitivity in the brain" itself).

And to think, some people are still seeing physicians who feel this is all psychological…

P.S. — For those of you who think there is nothing that can help your pain, the chapter on nerve pain in my book, Pain Free 1-2-3, will teach you how to effectively eliminate nerve pain. Click here to see a brief summary of options for nerve (and fibromyalgia) pain that can get you pain-free while we treat the underlying causes of your pain. It is very unusual for us not to be able to get people adequate pain relief—usually without narcotics. Sadly, most physicians are simply not trained in (and are clueless about) pain management. To find a physician who can eliminate the causes of your Fibromyalgia pain, go to www.fibroandfatigue.com. To find a good pain specialist for general pain, visit the American Academy of Pain Management.

Characteristic Electron Microscopic Findings in the Skin of Patients with Fibromyalgia—Preliminary Study

SH Kim, DH Kim, DH Oh, and DJ Clauw
Clin Rheumatol, March 1, 2008; 27(3): 407-11.
Dongguk University College of Medicine, Gyeongju, South Korea. junjan@dongguk.ac.kr

This blinded study was done to determine if there are any abnormal electron microscopic (EM) findings in the skin of Fibromyalgia Syndrome (FMS) patients, which might contribute to or be due to the increased pain sensitivity seen in this condition. Skin biopsy samples were obtained from 13 FMS patients and 5 control subjects. All tissues were prepared for EM examination by immediate prefixation in 2.5% glutaraldehyde for 2 h and postfixation in 1% osmium acid for 24 h. Ultrathin sections on grids were stained by uranylacetate and lead citrate. Biopsies were read by an individual without knowledge of participant status. Five skin biopsies from healthy controls showed relatively even distribution of variegated sized unmyelinated axons sheathed well by complicatedly folded Schwann cell membranes. In tissues from 9/13 FMS patients, unmyelinated Schwann cells were noted to be ballooned, whereas this finding was not noted in any controls (p=0.029). Axons in most patients trended towards being localized in the periphery of the unmyelinated Schwann cell sheaths (p=0.002). Particularly, peripheral localization of axon in the unmyelinated Schwann cell sheath had a strong relationship with ballooning of Schwann cell (p=0.042), simplified folding of Schwann cell sheath (p=0.039) and smaller axon (p=0.034). Myelinated nerve fibers were unremarkable. The EM findings seen in the skin of FMS patients show unusual patterns of unmyelinated nerve fibers as well as associated Schwann cells. If these findings are replicated in a larger study, these abnormalities may contribute to, or be due to, the lower pain threshold seen in FMS patients.

Publication Type: Journal article
PMID: 18323007