June 13, 2023 – In 1993, Lynne Matallana led a “wonderful life.” The newly married 38-year-old Californian was a partner in an promoting agency. But after an operation for endometriosis, her life was turned the wrong way up.
“I woke up during the surgery and the next day I was in unbearable pain – beyond unbearable – and was bedridden,” she said. The pain led to insomnia, inability to eat and debilitating exhaustion. “It was completely life-changing and I had no idea what had happened.”
Matallana went from doctor to doctor for the subsequent two years until she finally received the diagnosis: Fibromyalgia“It was a relief to have a diagnosis and finally a name for what was happening to me, and I've heard a lot of other people say the same thing,” she said.
Still, she said, “this was 1995 and not much was known about fibromyalgia, and the doctors basically said there was nothing they could do for me.”
Pain and the brain
Unfortunately, Matallana's story is typical. Although fibromyalgia is sort of common and affects more people than 5 million Americansit continues to be misdiagnosed and misunderstood. In fact, it may take a mean of as much as 5 years for a patient to be diagnosed with fibromyalgia.
Fibromyalgia may be brought on by physically or emotionally stressful events, comparable to a serious injury, a automotive accident, or certain viruses. Women are more at risk of fibromyalgia. Symptoms include extreme fatigue, difficulty concentrating and remembering things (sometimes called “fibro fog” or “brain fog”), insomnia, nervousness, and depression. Pain (typically within the muscles and joints) is one in all the major symptoms.
And because pain is a subjective experience—nobody can feel one other person’s pain—some health professionals have didn’t take symptoms seriously. Many patients diagnosed with fibromyalgia by a rheumatologist or pain medicine specialist say they were told by one other doctor that “Fibromyalgia does not exist.”
Hopefully this trend is now starting to alter as more research finds “objective” ways to discover the pain related to fibromyalgia.
In a recent study Researchers used MRI Data to review the brain regions involved in pain processing and emotional appraisal and located that these areas undergo changes in patients with fibromyalgia. The changes affect the dimensions of the grey matter within the brain, which accommodates neurons, and in addition the white matter, which is especially made up of fiber connections whose job it’s to transmit signals between nerve cells.
The researchers compared MRI data from 23 women with fibromyalgia and 21 healthy individuals.
“One of our goals was to find out whether there are differences in the diffusion direction of water molecules in certain brain regions, i.e. whether we can detect regional differences in signal transmission,” says study leader Benjamin Mosch, a doctoral student on the University of Bochum. said in a press release.
The researchers found changes in the amount of gray matter within the brain's pain network. “We discovered a reduction in gray matter in certain regions responsible for pain inhibition in patients compared to healthy controls. The volume of these regions was significantly reduced in the patients,” said Mosch.
Changes were also present in signaling within the thalamus, a brain region that plays a central role in pain processing. The differences in white matter between patients and healthy controls suggested that there have been changes in pain signals in individuals with fibromyalgia.
The researchers also investigated how these structural changes within the brain were related to the themes' perceptions and behavior. They found that the greater the amount loss in certain brain regions, the more pain individuals with fibromyalgia felt.
Changes within the brain may be reversed
When researchers analyzed the connection between depression symptoms or activity levels and volume changes in certain brain regions, they found that the amount of a region called the putamen was smaller in individuals with more severe depression symptoms, but larger in individuals with higher activity levels.
“This suggests that changes in the brain may not be permanent, but can be influenced – that is, they could be reversible, for example through an active daily life,” says Mosch.
These results are neither “new nor surprising,” said Dr. Daniel Clauw, professor of anesthesiology, rheumatology and psychiatry on the University of Michigan, in an interview.
The changes within the brain “are not permanent – these parameters often normalize with effective therapies,” said Clauw, who can also be director of the university's Research Center for Chronic Pain and Fatigue.
He said certain medications – including some antidepressants, so-called selective serotonin-norepinephrine reuptake inhibitors (SNRIs) and gabapentinoids, that are used to treat shingles, restless leg syndrome and seizures – in addition to non-drug therapies comparable to education, exercise and cognitive behavioral therapy are helpful in fibromyalgia and should help reverse a few of the brain changes.
Matallana, co-founder and director of the National Fibromyalgia Association, said that while the study doesn’t contain any dramatically recent findings, “when it comes to research on pain, people really need to hear the same thing over and over again before the medical system decides that pain is a real thing.”
For her, the study is “another step to prove that the pain of fibromyalgia actually has a biological cause and that changes can actually be detected in an MRI.”
More importantly, “the study shows that some of these changes are reversible. This is especially important because people need to know that they will not get worse over time and never have a quality of life again,” said Matallana, the creator of the book The Complete Idiot's Guide to Fibromyalgia.
Today, Matallana still suffers from a few of the symptoms of fibromyalgia, comparable to increased sensitivity to noise and smells and difficulty sleeping. “It's clear that my central nervous system is much more sensitive than other people's,” she said. Fortunately, she not has full-body pain.