Ordinary Touches Multiply
into Severe Pain for
Fibromyalgia Patients
By Eric Benjamin Lowe
The millions of Americans who suffer from fibromyalgia live with a two-edged
sword: excruciating pain, accompanied by the doubts of many who dismiss it as
a made-up illness invented by a troubled mind.
But researchers at the University of Florida and elsewhere are beginning to
piece together clues that reveal the physical basis of the puzzling syndrome
that causes severe fatigue and aches, and has defied easy diagnosis.
UF scientists have found an abnormal central nervous system reaction in those
with fibromyalgia-the body magnifies ordinary repetitive stimulation into an
experience of crippling pain.
“This is particularly important because it has been unclear if fibromyalgia
was just an imagined illness or a real syndrome,” said Dr. Roland Staud, an
associate professor of medicine at UF’s College of Medicine who also is
affiliated with the UF Brain Institute. “We now have good evidence that shows
that it’s not a psychological abnormality, but that there is a neurological
abnormality present.”
Staud, who presented his research findings at the annual meeting of the
American College of Rheumatology last November, recently was awarded a
National Institutes of Health grant worth nearly $800,000 to continue his
studies for the next four years. Donald Price, a UF professor of oral and
maxillofacial surgery, and Charles Vierck, a UF professor of neuroscience,
are collaborating on the research. Their goal is to develop a better
understanding of the condition, with an eye toward improving diagnostic tests
and treatments.
An estimated 3.7 million people in the United States – primarily women who
are diagnosed during their 30s and 40s – have fibromyalgia, according to the
NIH. A chronic illness with no known cure, its cause also is not known.
Researchers have theorized that an injury to the central nervous system or an
infectious agent might be responsible for triggering it in people who have
inherited susceptibility. Symptoms include persistent and widespread
musculoskeletal pain, fatigue and tenderness in the neck, spine, shoulders
and hips.
Staud and colleagues found the central nervous system abnormality by
conducting a series of repetitive stimulation tests on people with the
syndrome as well as healthy research participants. The tests involved
repeatedly placing warm plates on their hands and arms. The healthy
participants felt the sensation but did not report it as pain.
For those with fibromyalgia, however, the sensation would magnify with each
repetition into an experience of crippling and unbearable pain.
“When a sensation signal reaches the spinal cord, the signal can be omitted,
changed or augmented,” Staud said. “If it is augmented, then something that
is innocuous, such as pressure on the skin, can then be perceived as a
painful stimulus.”
Jessica LeMay, one of Staud’s patients, has been battling fibromyalgia since
1993. The 30-year-old Lake City resident said the pain starts in one area and
usually spreads, sometimes becoming overwhelming.
“I imagine if someone had taken a baseball bat and beaten me with it, that’s
got to be what it feels like,” she said. “Depending on the day, I’ll just
move out of the way if someone tries to touch me.”
The pain of fibromyalgia often interferes with a person’s working life.
“These are people who are diagnosed in their productive years. Many have
personal or professional problems adjusting to the pain experience,” Staud
said. “The illness makes some people feel dysfunctional because they can’t do
the activities they once did.”
The condition can worsen from stress and inadequate sleep, Staud said.
Because living with fibromyalgia often causes stress, and pain makes sleeping
difficult, a vicious cycle develops.
LeMay said many people dismiss her condition, not understanding the “huge
difference” between her severe fatigue and the healthy person’s occasional
tiredness. “When this fatigue would come about, it’s almost like a weight
being dropped on you, and you can’t function anymore,” she said. LeMay said
she is hopeful that Staud’s research will lead to more effective treatment
for fibromyalgia patients and better understanding by the general public.
“In our society, you either get better or you die, and fibromyalgia patients
don’t do that,” she said. “We don’t fit in the mold, so people don’t know
what to do with us.”
