Where does the pain in fibromyalgia come from?

Those who have fibromyalgia syndrome could have an increased intramuscular pressure, which could represent a new diagnostic aid in fibromyalgia syndrome and be a target for therapy to lessen muscle pressure, based on a study just published in The Journal of Rheumatology.

“This study directs attention to a peripheral target for both diagnosis and treatment that is not routinely monitored in clinical practice; intramuscular pressure, and hopefully provides a revised roadmap for a better understanding of pain in fibromyalgia syndrome,” wrote the authors, led by Robert S. Katz M.D., of the Rush Medical College from Chicago, Illinois.

People with fibromyalgia syndrome experience chronic pain, that is thought to come about via disordered central processing. The initial drugs for this chronic pain include things like pregabalin, duloxetine and milnacipran, that are useful to relieve the assumed central nervous system effect on widespread musculoskeletal pain. In the research, they question the common model of pain in fibromyalgia syndrome, looking to demonstrate that pain over the muscles is connected to increased intramuscular pressure.

The research included 108 people who met the American College of Rheumatology (ACR) requirements for fibromyalgia syndrome and 30 people who met the ACR criteria for a different rheumatic condition. Trapezius muscle pressure was assessed and participants had dolorimetry testing, digital palpation, and documented their pain scores.

The degree of pressure within the trapezius muscle of people with fibromyalgia syndrome resting was nearly 22 mm Hg higher than the pressure of the controls, with a mean pressure of 33.48 mm Hg versus 12.23 mm Hg, respectively. In 98 % of people with fibromyalgia syndrome, a pressure reading of 23 mm Hg or higher was recorded, which is greater when compared to a normal resting value of around 8 mm Hg.

People with fibromyalgia syndrome had been more tender than controls according to both dolorimetry and digital palpation (p<0.001 for both). The average pain rating in people with fibromyalgia syndrome and people with another rheumatic disease was 6.68 and 1.43, respectively (p<0.001). The researchers mentioned that these results are in line with prior evidence showing that pain and tenderness are frequent in the trapezius muscle of people with fibromyalgia syndrome, however they recommended that this pain/pressure connection needs more research.

“This is the first evidence of an abnormality in muscle pressure in fibromyalgia syndrome,” the researchers wrote. “Methods to reduce intramuscular pressure may be therapeutic.”

Mayo Clinic on Fibromyalgia: Strategies to Take Back Your Life
  • Abril M.D., Andy (Author)
  • English (Publication Language)
  • 272 Pages - 09/24/2019 (Publication Date) - Mayo Clinic Press (Publisher)

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Michael Administrator
My name is Michael and I have had fibromyalgia for a very long time. I have tried everything and nothing for it. Everything has worked and nothing has worked. It is a constant battle to find a glimmer of anything that may help, even a little bit. I hope I can help you.