Fibromyalgia — A Nerve Pain Disorder?

What is fibromyalgia?

Fibromyalgia is a health condition that involves pain, stiffness, sleep issues, fatigue, memory problems, and concentration challenges. In the past, fibromyalgia was thought to be related to muscle and ligament issues. Some experts even believed it was a psychogenic or somatoform disorder, meaning the symptoms were mental in nature and originated in an individual’s “head.” However, new research suggests that fibromyalgia may be a nerve pain disorder.

Fibromyalgia and nerve pain

The link between fibromyalgia and nerve pain has been investigated because many individuals with fibromyalgia experience numbness, tingling, sensory changes, and other symptoms that are typically associated with nerve pain. Their nerves appear to be more sensitive than they should be.

Small fiber neuropathy

Researchers now suspect that fibromyalgia may be related to a small fiber neuropathy (SFN), which is a structural abnormality of small nerve fibers. SFN is typically diagnosed through a skin biopsy. Individuals with SFN have reduced intraepidermal nerve fiber (IENF) density. New research shows that many individuals with fibromyalgia also have reduced IENF density.

Treatment of fibromyalgia as a nerve pain disorder

Categorizing fibromyalgia as a nerve pain disorder opens the door for various treatment options. In some individuals with both fibromyalgia and SFN, treatment for SFN, such as IV immunoglobulin, improves fibromyalgia symptoms as well as IENF density. Other treatments that work on the nervous system, such as sodium channel blockers, calcium channel blockers, and serotonin-norepinephrine reuptake inhibitors, may also be beneficial.

Importance of treatment

If neuropathy goes undiagnosed and untreated, symptoms can worsen and potentially become permanent. For this reason, it is important that individuals with fibromyalgia are checked for SFN. If evidence of SFN is found or if traditional fibromyalgia treatments are unsuccessful, treating the condition as a nerve pain disorder may improve symptoms.