What's going on in the Fibromyalgia Brain and Nervous System?

 In 'Key Milestones Contributing to the Understanding of the Mechanisms Underlying Fibromyalgia' two Australian researchers give a fascinating overview of what they consider to be the breakthrough findings in FM.

• Three nerves that transmit pain signals to the spinal cord have been found to be overactive in FM.

• Nerves should calm down and adjust to repeated stimulation, but in a process called windup the pain nerves that get activated in FM stay activated. They also respond more quickly to a stimulus and are apt to fire off spontaneously more.

• Twitchy nerves leading from around the spinal column could explain some of the upper body pain common in FM and the problems with bending, moving etc.

• Two neurotransmitters associated with pain, substance P and glutamate, have been found elevated in FM patients’ brains.

• The brain exerts enormous influence over the amount of pain we feel through a pain inhibition process which can reach all the way down the spinal cord.

• When one part of the body is exposed to pain, our sensitivity to pain in other parts of the body actually reduces. This process – called controlled pain modulation – is due to a pain inhibition process which begins in the brain.

• This process has been shown many times not to be working well in many, but not all, people with FM. Interestingly, although it’s not clear why, the low heart rate variability found in FM is associated with reduced pain inhibition. Mestinon is one drug that has proved helpful for some people with ME/CFS.

• Pain signals are believed to need to pass through a series of checkpoints or gates in order to make it to the brain. Those gates are believed to be opened wider than usual in FM.

• Some researchers, though, think that the pain inhibition process in FM is working just fine. They believe its signals are being overridden by a constant stream of pain signals emanating from the body.

• Brain scans show more problems. Blood flows to various parts of the brain are altered. The pain processing areas of the brain are hyperactive. Even when the brain is resting, it still maintains its tight connection to those areas.

• The authors of this study believe that widespread neuroinflammation could explain all the symptoms in FM.

• With so many validated issues in just the brain and nervous systems of FM patients, it seems incredible that any doctor worth his or her salt could dismiss this disease.

Thank you so much to Cort Johnson at Health Rising for all he does to help people with fibromyalgia, ME and CFS understand the scientific side of things. The above is the gist of one of his great articles so if you want to read the full explanation of this 2020 research please visit Cort's site. His article is called 'Wound up, Overheated and Tweaked: A Look at the Fibromyalgia Brain and Nervous System.'