(Second in a series of three posts on recent developments in our understanding of Fibromyalgia pain from Cort Johnson’s Health Rising.)
It turns out that every time you’re in pain and you contract a muscle, in what’s believed to be a protective reflex, that muscle contraction gets interrupted for a time
Prolonged delays in producing the ‘cutaneous silent period’ indicated that a key protective element is under-performing in FM
This is yet another example of a balky pain inhibition process ramping up pain levels in FM.
Two recent studies highlighted a ’hyperexcitable’ brainstem and highly activated brain neurons have been found in others. Inhibitory brain chemicals (serotonin) are reduced while excitatory brain chemicals (substance P, glutamate) are increased.
Meanwhile below the brain, small nerve fiber and blood vessel studies suggest exaggerated sensory inputs from the body are present.
Tramadol, interestingly enough, is able to increase the cutaneous silent period
Conclusion The finding that pain inhibition at the muscle level is hampered in fibromyalgia adds to the number of dysregulated pain producing pathways found in fibromyalgia. The possibility that small fiber neuropathy may be responsible is intriguing given increasing evidence it may play a major role in FM. It’s becoming clearer and clearer that the pain production problems in fibromyalgia are probably global; ie both the brain and the body are implicated…
Previous post in three-part Fibromyalgia series:
- Fibromyalgia Pain III: Study Suggests Muscles Are ‘Wired and Tired’