1993 – Studies demonstrate central sensitization and HPA axis (stress regulation) abnormalities;
1994 – Confirmation of elevated substance P (pain messenger) in cerebrospinal fluid;
1995 – First U.S. prevalence study shows fibromyalgia in 2% of the population;
1995 – First SPECT (brain imaging) showing abnormal blood-flow patterns in the brain;
1999 – First study demonstrating genetic component to explain why it runs in families;
2000 – Review of evidence coins the term central sensitization syndromes;
2005 – American Pain Society releases first guidelines for treating fibromyalgia pain;
2007 – Lyrica (pregabalin) becomes first FDA-approved treatment in the U.S. (Cymbalta (duloxetine) and Savella (milnacipran) followed, in 2008 and 2009, respectively;)
2010 – American College of Rheumatology releases alternate diagnostic criteriausing questionnaires instead of tender points.
Research has continued to shore up these findings as well as suggest new possible causal factors and mechanisms. As of early 2014, some lines of inquiry include:
Inflammation of the fascia: Some research has suggested that the widespread pain of fibromyalgia may indeed be inflammatory, but in the extremely thin body-wide web of connective tissue called fascia.
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Extra nerves on blood vessels: A much-publicized study shows extra temperature and pain-sensing nerves in the circulatory system.
Small-fiber neuropathy: Emerging research is showing that certain specialized nerves may be damaged.
Immune System Abnormalities: Some lines of research are showing abnormal activity in the immune system that may suggest chronic immune-system activation or autoimmunity. One study suggests an autoimmune reaction to serotonin. Another proposes a possible diagnostic test based on an immune profile.
Several researchers also are working to establish subgroups of fibromyalgia, believing that it’s the key to nailing down the underlying mechanisms and best treatments. More treatments are always under investigation, and a major goal has long been identifying and establishing objective diagnostic tools such as a blood test or scan.Fibromyalgia still has not found universal acceptance in the medical community, but it’s closer than ever. As research continues to demonstrate that it’s both real and physiological, this condition gains credibility and those of us with it gain understanding, respect, and, most importantly, better treatment options so that we can reclaim our futures.
Sources:
Ceko M, Bushnell MC, Gracely RH. Pain research and treatment. 2012;2012:585419. Neurobiology underlying fibromyalgia symptoms.
Chalaye P, et al. The Clinical journal of pain. 2012 Jul;28(6):519-26. Comparing pain modulation and autonomic responses in fibromyalgia and irritable bowel syndrome patients.
Culpepper L. The Journal of clinical psychiatry. 2012 Mar;73(3):e10. Management of fibromyalgia in primary care.
Miro E, et. al. Psicothema. 2012 Feb;24(1):10-15. Abstract accessed, article in Spanish. Fibromyalgia in men and women:
Comparison of the main clinical symptoms.
Staud R. Clinical and experimental rheumatology. 2011 Nov-Dec;29(6 Suppl 69):S109-17. Brain imaging in fibromyalgia syndrome.
long painful read but thank you…
Such an interesting article, this information needs to be made widely available. For me diagnosed with rheumatoid arthritis at 13 and then told in my 30s I had crohns disease and the rheumatologist said it was related to that. In my 50s being diagnosed with fibromyalgia after yrs of hell, I didn’t understand and felt like a fraud but as I increase my understanding reading articles like this it eases my mind if not my pain. Thank you