Fibromyalgia and Inflammation
Researchers have expected that chronic inflammation probably plays a role in the pathophysiology of fibromyalgia (FM). Neuro-inflammation is considered to be central to the pathophysiology of many chronic pain conditions. Proving this hypothesis appears to be challenging. Previous studies on fibromyalgia on human plasma/serum and/or cerebrospinal fluid (CSF)’s protein only looked at a few cytokine candidates and the results are inconclusive.
Instead of analysing only a few substances at a time, a new research study from Sweden analysed 92 inflammation-related proteins simultaneously. The research was published in Journal of Pain Research. The researchers investigated the CSF and plasma inflammatory profiles of 40 fibromyalgia patients compared with CSF from healthy controls (n=10) and plasma from blood donor controls (n=46). The authors found evidence of both neuro-inflammation (as assessed in CSF) and chronic systemic inflammation (as assessed in plasma). This study provides a concrete evidence for an extensive inflammatory profile in fibromyalgia patients. This dispels the myth that it is all in the head, or idiopathic, or even psychogenic.
The authors also clearly stated the limitation of this study (fibromyalgia patients were all female and the control is limited). The authors further hypothesize possible mechanisms, including (1) central sensitization due to neuro-inflammation, (2) an inflammatory risk factor that was present prior to the development of chronic pain (e.g., a genetic susceptibility), and (3) a consequence of the chronic pain condition, e.g. pain-related stress, inactivity , depression, etc.
Interestingly, inflammatory profiles similar to those now found in fibromyalgia have been previously observed in studies of both chronic pain and neuropathic pain. Til Luchau, author and instructor of myofascial therapy commented: “Fibromyalgia seems to respond to manual therapy similarly to chronic pain conditions. Empirically, both fibromyalgia and chronic pain can, in many cases, be easily aggravated by too-direct, too-fast, too-long, or too-frequent work; or can show symptoms that seem to move around; or seem linked with mental or emotional agitation, depression, inactivity, and poor sleep. Manual therapists who have worked with fibromyalgia and chronic pain have learned that the best results seem to come when their treatment takes into account the entire nervous system’s (or entire person’s) level of sensitivity, activation, resource, and resilience; and that duration, pressure, pace, and frequency all need to carefully be tuned to the individual’s response (which can be different every time).”
“Personally, my ears perk up whenever there’s a new development around the immune system’s relationship to pain; we have a lot to learn about inflammation, and are still elaborating the larger principles of how and when our work can be most effective with inflammatory conditions; and of course, how our approach might need to adapt or expand in order to best help clients and patients with either chronic pain and/or fibromyalgia.”
This blog post article was reproduced with permission from Terra Rosa.