Headline: Fibromyalgia Solved (not really)

Fibromyalgia solved; A pathology, not in the mind | Washington Times Communities

Fibromyalgia solved?  Absolutely NOT true.  This is what happens when “health reporters” with limited medical knowledge write attention grabbing articles.  The facts are mostly right, the explanation is adequate, but the interpretation and conclusion are completely unfounded.

Dr. Frank Rice writes of findings at Integrated Tissue Dynamics that has made a major discovery of the cause of fibromyalgia making diagnosis more certain and explaining the multitude of varied symptoms and effects.

Nowhere in the research or on the company’s website does it say anything about the “cause of fibromyalgia” – this is pure invention on the writer’s part.

When we use our muscles, particularly the hands and feet, the blood flow between the skin and muscles must be kept in balance. We have internal thermostats distant from the hypothalamus called aterio-venous shunts or AV shunts that act as valves between arterioles or veins that supply the good stuff and venules which carry away waste

it has been discovered when the AV shunt is defective in function and interferes with capillary function, muscle and skin tissue cannot get proper nutrition or waste drawn away. Additionally, temperature regulation becomes an issue affecting nerve fibers.

The result is a build-up of lactic acid in muscle and deeper tissue affecting the muscular system and causes pain that can seem to ‘travel’ from areas of the body one day to the next and cause fatigue.

The Journal of Pain Medicine featured this research on its front cover

According to this research, fibromyalgia has pathology and is not psychosomatic so those who suffer from this ‘syndrome’ can now rest assured it is not all in their minds

Several researchers have already discovered anomalies in temperature regulation processes in the skin of FMS patients, so this is only an expansion of previous research, not a breakthrough of any kind.

Here is a critique of the flawed extrapolation and over-simplification of the study by a rheumatologist:

Rheumatologe: Fibromyalgia and Excessive Peptidergic Sensory Innervation of Cutaneous Arteriole-Venule Shunts (AVS) in the Palmar Glabrous Skin

The problem lies in the selection of patients and the small number (N=24). Who knows if this is only found in fibromyalgia patients and not also in patients suffering from hypertension, other forms of chronic pain, and so on?

“and the discovered pathology involving the nerve endings to the shunts provides a logical explanation for the widespread deep pain and fatigue symptomatic of fibromyalgia.” It isn’t a logical explanation, it’s one hypothesis of more possible ones – and an unproven one.

And here is the study upon which the headline was based:

Excessive peptidergic sensory innervation of cutane… [Pain Med. 2013] – PubMed – NCBI

RESULTS: AVS had significantly increased innervation among FM patients.

CONCLUSIONS: The excessive sensory innervation to the glabrous skin AVS is a likely source of severe pain and tenderness in the hands of FM patients. Importantly, glabrous AVS regulate blood flow to the skin in humans for thermoregulation and to other tissues such as skeletal muscle during periods of increased metabolic demand. Therefore, blood flow dysregulation as a result of excessive innervation to AVS would likely contribute to the widespread deep pain and fatigue of FM. SNRI compounds may provide partial therapeutic benefit by enhancing the impact of sympathetically mediated inhibitory modulation of the excess sensory innervation.