Many Fibromyalgia Patients Have Small-Fiber Polyneuropathy
This also means that many patients are trapped in a cycle of failed therapies and no clear curative treatment for the widespread chronic pain condition that can cause neck pain, shoulder pain, fatigue, and cognitive symptoms.
This research may provide an opportunity for specific testing and tailored treatment that can make a huge difference to quality of life for fibromyalgia sufferers.
A Target for Fibro Treatment?
This latest fibromyalgia research was carried out at Massachusetts General Hospital by Anne Louise Oaklander, MD, PhD, and colleagues from Harvard Medical School in Boston. Details of the work were presented late last month at the American Neurological Association (ANA) 137th Annual Meeting and Oaklander hopes that small-fiber polyneuropathy (SFPN) could represent a target for effective treatment for many patients.
SFPN and Fibromyalgia – Similarities and Differences
Fibromyalgia differs from SFPN in that the latter is a true disease with objective tests for diagnosis and the possibility of disease-modifying treatments. However, the symptoms of fibromyalgia and SFPN are very similar with widespread chronic pain, including neck pain, and tender points found in both conditions.
Skin Punch Biopsies and Other SFPN Tests
During this latest research, the scientists looked at twenty-five patients meeting the criteria for clinical diagnosis with fibromyalgia. These patients were all over eighteen years old (mean age was 46.5) and they were demographically matched with controls (average 44.8 years old). Just as the majority of those diagnosed with fibromyalgia are women, so it was in this study that 76-79% of patients and controls were women. All patients were tested for SFPN using standard diagnostics autonomic function testing, an early neuropathic scale, and PGP9.5 immunohistochemical staining of a 3mm skin punch biopsy specimen.
Nerve Loss in Fibromyalgia Patients
As nerve fiber density differs between men and women and young and old, the tests and markers were normalized and analyzed in a blinded fashion to remove bias. Small-fiber polyneuropathy is diagnosed when a patient’s nerve fiber density is below the fifth percentile for their predicted value, given their age and sex. Half of the fibromyalgia patients showed evidence of nerve loss, with 46% meeting strict criteria for SFPN (17% of controls also met these criteria). Using just the IENF staining testing method, some 40% of the fibromyalgia patients met SFPN criteria but there was no overall difference between fibromyalgia patients and controls on autonomic function testing (17% of the former met SFPN criteria, versus 15% of controls).
Diabetes and Fibromyalgia – What’s the Connection?
These results will hopefully go some way towards helping physicians apply appropriate testing to patients they suspect have SFPN. IENF densities were 28% (plus or minus 6%) of the predicted norm for fibromyalgia patients, whereas they were 47% (plus or minus 6%) for controls. Diabetes is the most common cause of loss of nerve fiber density and small-fiber polyneuropathy in people in the US and many remain unaware that they have diabetes or prediabetes. Uncovering a possible cause of pain in those diagnosed with fibromyalgia could lead to further testing to determine if diabetes, prediabetes or some other condition is at the root of nerve pain. Thus, restoring healthy blood sugar control may, theoretically, reduce symptoms of fibromyalgia in some patients.
Misdiagnosing Neck Pain and Fibromyalgia
There is a real concern that patients with neck pain attributable to no clear cause are given a diagnosis of fibromyalgia and then struggle to undergo further testing to elucidate the cause of their suffering. Decades of pain can cost patients the opportunities for happy and fulfilling careers, relationships and family life, but understanding the real cause of fibromyalgia may change all that.
Treatable Causes of SFPN
Autoimmune conditions, tumors, neurotoxins, genetic mutations, and other causes of SFPN could all be treated and symptoms of pain associated with fibromyalgia may dissipate with such therapy. SFPN can also affect blood pressure homeostasis, gastrointestinal function and other systems not normally connected with simple pain in the neck or chronic pain from fibromyalgia. The often confusing medical and symptom history of patients finally diagnosed with fibromyalgia may incorporate dizzy spells, digestion problems, cognitive symptoms, weakness, numbness and paraesthesia in the limbs, and fatigue, stress and depression.
Testing Fibro Patients for SFPN
SFPN may account for many of these symptoms but, as patients with suspected fibromyalgia are usually sent to a rheumatologist rather than a neurologist such a diagnosis is unlikely to be foremost in the physician’s mind. That this recent study found half of fibromyalgia patients had small-fiber polyneuropathy may change diagnostic procedures for patients presenting with neck pain and other symptoms of fibromyalgia.
Reference
American Neurological Association (ANA) 137th Annual Meeting in partnership with the Association of British Neurologists. Abstract W1409. Poster presented October 7-9, 2012.
prescription drugs canada buy online discount prescription drugs
https://drwithoutdoctorprescription.site/ п»їed drugs online from canada
canadian online drugstore buy prescription drugs without doctor
ed meds online without doctor prescription amoxicillin without a doctor’s prescription
is cialis from india safe ? tadalafil 20mg
buy prescription drugs online legally ed meds online canada
how to get prescription drugs without doctor canadian drugs
buying viagra online viagra cost
https://sildenafilmg.com/ where to buy viagra online
mexican viagra sildenafil
viagra cost per pill best place to buy viagra online
https://sildenafilmg.shop/# viagra cost
best place to buy generic viagra online viagra over the counter
https://sildenafilmg.online/# cost of viagra
viagra viagra cost per pill
cost of viagra when will viagra be generic
buy viagra online canada best over the counter viagra
cheap doxycycline 100mg capsule buy doxycycline 50 mg
doxycycline otc drug purchase doxycycline online
doxycycline 100mg coupon cost of doxycycline 50 mg
https://prednisoneforsale.store/# where to buy prednisone 20mg
10mg prednisone daily buy prednisone without rx
can you buy prednisone over the counter in usa prednisone 20mg cheap
where can i buy doxycycline in singapore doxycycline 300 mg
buy doxycycline 100mg cheap buy cheap doxycycline uk
https://doxycyclineforsale.life/# vibramycin
https://buymetformin.best/# drug cost metformin
buy nolvadex online tamoxifen alternatives
https://buylasix.icu/# lasix online
https://buytadalafil.men/# generic tadalafil medication
where can i buy nolvadex tamoxifen blood clots
lipitor generic brand buy lipitor from canada
https://buynolvadex.store/# where to buy nolvadex
metformin otc metformin without prescription
https://diflucan.icu/# diflucan otc australia
ed medication best ed drug
neurontin 200 mg tablets can i buy neurontin over the counter
https://gabapentin.icu/# medication neurontin
Hi there! I know this is somewhat off topic but I was wondering if you knew where I could get a captcha plugin for my comment form? I’m using the same blog platform as yours and I’m having problems finding one? Thanks a lot!
Neat blog! Is your theme custom made or did you download it from somewhere?
A theme like yours with a few simple adjustements would really make my
blog shine. Please let me know where you got your theme.
Appreciate it save refuges
diflucan online pharmacy can i buy diflucan from canada
https://diflucan.icu/# cost of diflucan in canada