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OKIsItJustMe

(19,938 posts)
Tue Jun 18, 2013, 09:48 AM Jun 2013

Fibromyalgia Is Not All In Your Head, …Researchers discover a…source of pain in the skin of patient

http://www.intidyn.com/Newsroom/article-0009.html
[font face=Serif][font size=5]Fibromyalgia Is Not All In Your Head, New Research Confirms Researchers discover a rational biological source of pain in the skin of patients with fibromyalgia[/font]

[font size=3]{June 14, 2013, Rensselaer, NY} – Fibromyalgia, a painful condition affecting approximately 10 million people in the U.S., is not imaginary after all, as some doctors have believed. A discovery, published this month in PAIN MEDICINE (the journal of the American Academy of Pain Medicine), clearly now demonstrates that fibromyalgia may have a rational biological basis located in the skin.

Fibromyalgia is a severely debilitating affliction characterized by widespread deep tissue pain, tenderness in the hands and feet, fatigue, sleep disorders, and cognitive decline. However, routine testing has been largely unable to detect a biological basis for fibromyalgia, and standard diagnosis is based upon subjective patient pain ratings, further raising questions about the true nature of the disease. For many years, the disorder was believed to be psychosomatic (“in the head”) and often attributed to patients’ imagination or even faking illness. Currently approved therapeutics that provide at least partial relief to some fibromyalgia patients are thought to act solely within the brain where imaging techniques have detected hyperactivity of unknown origin referred to as “central sensitization.” However, an underlying cause has not been determined, leaving many physicians still in doubt about the true origins or even the existence of the disorder.

Now, a breakthrough discovery by scientists at Integrated Tissue Dynamics LLC (Intidyn), as part of a fibromyalgia study based at Albany Medical College, has provided a biological rationale for this enigmatic disease. The small biotechnology research company, founded by neuroscientists Dr. Frank L. Rice and Dr. Phillip J. Albrecht, reports on a unique peripheral neurovascular pathology consistently present in the skin of female fibromyalgia patients which may be a driving source of the reported symptoms.

“Instead of being in the brain, the pathology consists of excessive sensory nerve fibers around specialized blood vessel structures located in the palms of the hands,” said Dr. Rice, President of Intidyn and the senior researcher on the study. “This discovery provides concrete evidence of a fibromyalgia-specific pathology which can now be used for diagnosing the disease, and as a novel starting point for developing more effective therapeutics.”

…[/font][/font]
http://dx.doi.org/10.1111/pme.12139
19 replies = new reply since forum marked as read
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Fibromyalgia Is Not All In Your Head, …Researchers discover a…source of pain in the skin of patient (Original Post) OKIsItJustMe Jun 2013 OP
Womens Health WovenGems Jun 2013 #1
I know two fibromyalgia sufferers OKIsItJustMe Jun 2013 #2
Well WovenGems Jun 2013 #3
many fibro and chronic fatigue cases are related to Ehlers-Danlos joint hypermobility zazen Jun 2013 #4
You’re welcome! OKIsItJustMe Jun 2013 #6
whew mopinko Jun 2013 #5
Yay for science! Hydra Jun 2013 #7
The use of terms like "all in our head", "rational" and "imaginary" are insulting cbayer Jun 2013 #8
“…psychological underpinnings of this disorder…” OKIsItJustMe Jun 2013 #9
You may be right, but you may be wrong. cbayer Jun 2013 #10
Do you mean “psychological” or “psychiatric?” OKIsItJustMe Jun 2013 #11
I'm not sure there is a bright line distinction. cbayer Jun 2013 #12
There is a "bright line distinction" OKIsItJustMe Jun 2013 #13
Yes, there is a very bright line when describing professionals that treat mental disorders. cbayer Jun 2013 #14
Clearly, you like psychiatry (i.e. you prefer to treat people with drugs) OKIsItJustMe Jun 2013 #15
Whoa, wait a minute. I'm not sure how you reached that conclusion. cbayer Jun 2013 #16
Actually, you are wrong Warpy Jun 2013 #17
The data doesn't back you up. cbayer Jun 2013 #18
With regards to whether it is psychological or not - hedgehog Jun 2013 #19

WovenGems

(776 posts)
1. Womens Health
Tue Jun 18, 2013, 10:05 AM
Jun 2013

Fibro has always been real. Bone heads, and they market meaningless drugs for it, decided it as brought on by depression. Wrong. The same applies to migraines. I have had one migraine in my life. And when I described the incredibly weird headache I had she said "OK, brainy brother of mine tell me what a migraine is." I said "It is not related to a headache. Its closest medical relative is epilepsy". Her response summarized rather well what is wrong with our medicine. "So how come nobody in medicine has figured that out?"

OKIsItJustMe

(19,938 posts)
2. I know two fibromyalgia sufferers
Tue Jun 18, 2013, 10:45 AM
Jun 2013

Both of them eventually found Dr's who took their pain seriously, but, both, at times, wondered if it was all in their heads…

WovenGems

(776 posts)
3. Well
Tue Jun 18, 2013, 10:49 AM
Jun 2013

Technically pain is all in the head. The source of the pain signal is the question. When it comes to womens health our puritan based country drops the ball for a silly reason.

zazen

(2,978 posts)
4. many fibro and chronic fatigue cases are related to Ehlers-Danlos joint hypermobility
Tue Jun 18, 2013, 10:50 AM
Jun 2013

type, which is a connective tissue disease. There's some emerging consensus among geneticists and rheumatologists that EDS may be at the heart of a lot of these chronic "invisible" syndromes. Many EDS-III sufferers go for years with IBS, dysautonomia, POTS, joint dislocations, early onset osteoarthritis, debilitating fatigue, and fibro, and are told it's in their head and they're malingerers. Since estrogen makes you more stretchy, women are usually more symptomatic with EDS and bingo, are told we're crazy, naturally.

Something like 60-70% of chronic fatigue sufferers in one study met the criteria for joint hypermobility (which is pathognomonic for EDS-III).

Soo, I wonder if there's any connection between their work and EDS. I'll look into it. Thanks for the link.

cbayer

(146,218 posts)
8. The use of terms like "all in our head", "rational" and "imaginary" are insulting
Tue Jun 18, 2013, 01:59 PM
Jun 2013

Psychosomatic disorders are real and, as the name implies, indicative of disorders that have both psychological and neurological causes and manifestations.

It is no surprise that there are neurological markers that may explain some of the symptoms of FM. If that leads to more effective treatments, that's a good thing.

The authors of this article are trying to make the case that this shows it is a purely neurological disorder, but the authors of the research appear to make no such claim.

To dismiss, and even denigrate, the psychological underpinnings of this disorder is a mistake and further marginalizes those with psychiatric disorders as having imaginary and irrational illnesses.

Shame on them.

OKIsItJustMe

(19,938 posts)
9. “…psychological underpinnings of this disorder…”
Tue Jun 18, 2013, 02:17 PM
Jun 2013

I believe you have made an unwarranted assumption.

For example, I know for a fact that one of the fibromyalgia sufferers also suffers from raynaud's disease (I don’t know whether the other one does or not.)

To me, this research suggests that the two (fibromyalgia and raynaud’s) may be related. (Both affect women more often than men.)

Assuming that this disease has “psychological underpinnings” (if it has a physical cause) seems likely to me to lead to mistreatment. (i.e. Treating the symptoms, rather than the cause.)

cbayer

(146,218 posts)
10. You may be right, but you may be wrong.
Tue Jun 18, 2013, 02:38 PM
Jun 2013

Failing to investigate and take seriously both the psychiatric and neurological underpinnings of disorders like this is a mistake. It is no victory to proclaim that it is "real" only if it is purely neurological.

Patients with FM benefit most with their whole person is addressed, including underlying psychiatric conditions that may cause, contribute to or exacerbate it.

By dismissing the psychiatric/psychological aspects of all kinds of illnesses, medicine often misses the mark. This leads to bad medicine and increased/unnecessary costs.

OKIsItJustMe

(19,938 posts)
11. Do you mean “psychological” or “psychiatric?”
Tue Jun 18, 2013, 02:59 PM
Jun 2013

I believe the (presumed) “psychological underpinnings” (as you put it before) have been rather thoroughly investigated already. (Perhaps too thoroughly.)
http://www.google.com/search?q=fibromyalgia+psychological

cbayer

(146,218 posts)
12. I'm not sure there is a bright line distinction.
Tue Jun 18, 2013, 03:21 PM
Jun 2013

Psychology may have a broader definition, but what I refer to are brain disorders that may or may not be rooted in biological causes or emotional causes or both.

Until the sufferers of disorders like these are able to obtain relief, there can never be too much study, imo.

The first link that comes up on your search is a very good and comprehensive review. This is one of it's primary conclusions:

While the central theme of the present review is that chronic stress may lead to changes in various hormones and neurotransmitters, resulting in various manifestations of fibromyalgia such as pain and fatigue, it is not inconceivable that the chronic pain present in fibromyalgia can give rise to psychological stress, and thereby cause changes in neuroendocrine axes.


There is a chicken/egg issue here, but most would not dispute that in some illnesses, including fibromyalgia, there are both psychiatric and neurological symptoms/causes and that each feed the other in very negative ways.

So to just treat one and ignore the other would be a mistake, imo.

OKIsItJustMe

(19,938 posts)
13. There is a "bright line distinction"
Tue Jun 18, 2013, 03:25 PM
Jun 2013
http://www.webmd.com/mental-health/features/psychology-vs-psychiatry-which-is-better
[font face=Serif][font size=3]…

The short answer is, psychiatrists are medical doctors and psychologists are not. The suffix "-iatry" means "medical treatment," and "-logy" means "science" or "theory." So psychiatry is the medical treatment of the psyche, and psychology is the science of the psyche.



As medical doctors, psychiatrists can do what most psychologists in the United States cannot: They can prescribe drugs.

…[/font][/font]

cbayer

(146,218 posts)
14. Yes, there is a very bright line when describing professionals that treat mental disorders.
Tue Jun 18, 2013, 03:32 PM
Jun 2013

The overlap occurs because "the psyche" is not just an ephemeral concept, but really comes down to the brain and neurotransmitters, etc.

It's a good thing that we are treating a lot of psychiatric disorders like "real" illnesses and not dismissing them as "all in one's mind".

FWIW, more and more states are granting prescribing privileges to psychologists. There are still major differences in education and training, but the distinction between what psychologists and psychiatrists treat is becoming much less clear.

OKIsItJustMe

(19,938 posts)
15. Clearly, you like psychiatry (i.e. you prefer to treat people with drugs)
Tue Jun 18, 2013, 04:02 PM
Jun 2013
http://www.guardian.co.uk/society/2013/may/12/psychiatrists-under-fire-mental-health
[font face=Serif][font size=5]Psychiatrists under fire in mental health battle[/font]

[font size=4]British Psychological Society to launch attack on rival profession, casting doubt on biomedical model of mental illness[/font]

Jamie Doward
The Observer, Saturday 11 May 2013

[font size=3]There is no scientific evidence that psychiatric diagnoses such as schizophrenia and bipolar disorder are valid or useful, according to the leading body representing Britain's clinical psychologists.

In a groundbreaking move that has already prompted a fierce backlash from psychiatrists, the British Psychological Society's division of clinical psychology (DCP) will on Monday issue a statement declaring that, given the lack of evidence, it is time for a "paradigm shift" in how the issues of mental health are understood. The statement effectively casts doubt on psychiatry's predominantly biomedical model of mental distress – the idea that people are suffering from illnesses that are treatable by doctors using drugs. The DCP said its decision to speak out "reflects fundamental concerns about the development, personal impact and core assumptions of the (diagnosis) systems", used by psychiatry.

Dr Lucy Johnstone, a consultant clinical psychologist who helped draw up the DCP's statement, said it was unhelpful to see mental health issues as illnesses with biological causes.

"On the contrary, there is now overwhelming evidence that people break down as a result of a complex mix of social and psychological circumstances – bereavement and loss, poverty and discrimination, trauma and abuse," Johnstone said. The provocative statement by the DCP has been timed to come out shortly before the release of DSM-5, the fifth edition of the American Psychiatry Association's Diagnostic and Statistical Manual of Mental Disorders.

…[/font][/font]


Psychiatry has its place. However, it is a different thing from psychology.

cbayer

(146,218 posts)
16. Whoa, wait a minute. I'm not sure how you reached that conclusion.
Tue Jun 18, 2013, 04:17 PM
Jun 2013

Isn't it more likely that someone will receive only drugs only if it is determined that fibromyalgia (and other disorders) is purely neurological.

My position is that it is both neurological and psychological/psychiatric. If that is recognized, then both aspects are more likely to be treated, including the use of psychotherapy or other cognitive/behavioral treatments.

The linked article would be funny if it weren't so scary. To say that chronic, severe mental illnesses like schizophrenia and bipolar disorder are not medical disorders has the potential to seriously harm patients with these illnesses. It has the potential to set the treatment of serious psychiatric illnesses back years.

I also have issues with the new DSM, but the psychologists are way off the mark here. Fortunately the American Psychological Association has taken no such position, and, as I pointed out earlier, many states are granting prescribing privileges to psychologists, who have been fighting for these privileges for years.

Warpy

(111,255 posts)
17. Actually, you are wrong
Wed Jun 19, 2013, 12:39 AM
Jun 2013

The psychological problems that sometimes are seen are a result of pain and disability. Plenty of people out there have clinical depression with no symptoms of myofascial pain.

You've simply stuck the cart ahead of the horse. It's supposed to go first, a painful, incurable and debilitating illness, then go on to develop psychological issues because being disabled and in pain sucks.

cbayer

(146,218 posts)
18. The data doesn't back you up.
Wed Jun 19, 2013, 01:17 AM
Jun 2013

It remains unclear - a chicken/egg situation.

Of course some people have depression without myofascial pain. That's not the issue.

You have taken the position that this is a neuromuscular disorder with psychiatric side effects. Many would disagree with you.

At any rate, I don't see any reason to make it one or another. Both aspects need to be addressed.

hedgehog

(36,286 posts)
19. With regards to whether it is psychological or not -
Wed Jun 19, 2013, 01:43 PM
Jun 2013

it turns out that my version of autoimmune disease (Sjogren's Syndrome) frequently is associated with depression. I don't think of one causing the other, but rather of both coming from the same group of causes. I suspect that this applies to a range of autoimmune disorders.

The stigma of looking for a psychological cause is two-fold. First, too many people still think of depression as an attitude problem - "just think positively and you won't be depressed" and/or a behavioral problem "if you'd only (get more sunshine, eat better foods, get moer sleep , get more exercise) you'd feel better." Thus, being told that fibromylagia is a psychological problem becomes code for "you're not really sick, you're making this up to get attention and/or get out of your responsibilities."
Second - if the treatment focuses only on anti-depressants, and they don't work or don't work well, the patient feels as if she has been blown off.

That said - if this is a disease of faulty nerve and/or nerve connections, some anti-depressants may be part of a treatment plan in conjunction with physical therapy, diet and/or other interventions.

The best take-away from this article is that this is the first time I've seen measurable evidence of a disease process. Even if you're the one experiencing the symptoms, there are days when you end up wondering if indeed you are making this up! When I try to explain to others my daughter's problems from fibromylagia, they think I'm making excuses for her. For me, the occasional brain fog and constant fatigue are the most difficult aspects of my disease. The dry skin, dry mouth and dry eyes are irritating but also reassuring. They tell me I really do have a problem, and that when I'm careful to pace myself, I'm not malingering but rather doing the right thing!

Thank you for this article!

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