Small-fiber neuropathy and fibromyalgia

An intriguing study done in the University of Würzburg and published in Brain march 9, 2013 indicates fibromyalgia pain is due to small fiber neuropathy. There has been the suggestion of nerve dysfunction in the past but this would demonstrate nerve damage. At one time fibromyalgia pain was thought to be in the muscles but there was no damage to the muscles to be seen so research moved up to the brain and there was plenty up there to be seen. While this was a generally small study it has impacted further research in this direction and brought more of an understanding about fibromyalgia as a syndrome.

The Study: Small fibre pathology in patients with fibromyalgia syndrome Brain first published online March 9, 2013

Twenty five fibromyalgia patients were involved in this study and “underwent comprehensive neurological and neurophysiological assessment. We examined small fibre function by quantitative sensory testing and pain-related evoked potentials, and quantified intraepidermal nerve fibre density and regenerating intraepidermal nerve fibres in skin punch biopsies of the lower leg and upper thigh.” (Study) The results were then compared with ten patients with depression and with healthy controls matched with age and gender.
Patients with fibromyalgia had higher scores in neuropathic pain questionnaires.

–Patients with fibromyalgia had impaired small fiber function “with increased cold and warm detection thresholds in quantitative sensory testing (P < 0.001)” which essentially leads to increased temperature sensitivity.

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