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A Key to Fibromyalgia Pain Discovered

Feeling like we have a degree of control increases tolerance to pain. But for those with fibromyalgia, this doesn’t work and a recent study yielded results that may explain why.

Fibromyalgia is a mysterious chronic pain disorder that is difficult to treat—it was added to the World Health Organization’s catalogue in 1994 so there is much for science yet to discover about this illness. Its causes are also still largely unclarified.

A study conducted by the team at the Clinic for Psychosomatic Medicine and Psychotherapy at Ruhr University Bochum, Germany, provides evidence that certain brain areas involved in processing pain don’t function normally in fibromyalgia patients. In healthy people, they ensure that pain that we can control is easier to bear. The study found that these brain areas showed altered activity in patients with fibromyalgia.

The degree to which we experience pain and the restriction caused by it depend largely on how we perceive it. If we have the feeling that we can control the pain and shut it down ourselves, for example, we will tolerate it better than if we feel at its mercy. “For people with chronic pain, the inability to control repeated attacks of pain is one of the most significant causes of impaired quality of life,” explained Benjamin Mosch, lead author of the study. “And yet, the underlying neural mechanisms have so far mainly been studied in healthy controls.”

In the current study, the team compared two female cohorts: 21 healthy participants and 23 fibromyalgia patients. Both groups were exposed to heat pain while their brain activities were monitored by functional magnetic resonance imaging. In one experimental run, the participants were able to stop the pain stimulus themselves. In another run, a computer controlled the start and end of the stimulus. “We kept the duration of the stimuli terminated by the computer the same on average as the stimuli terminated by the test subjects,” said team leader Prof. Martin Diers.

When women in the healthy control group were able to terminate the pain stimulus themselves, a number of mainly frontal brain areas were activated that seem to play an important role in modulating pain. This observation is consistent with previous studies involving healthy subjects. “Interestingly, however, we didn’t detect any such activations in our patient group,” commented Diers. “This can serve as evidence for impaired pain processing among patients with fibromyalgia. It indicates that the cognitive resources for dealing with acute pain are impaired in these patients.”

References:

Mosch B, et al. “Neural correlates of control over pain in fibromyalgia patients.” NeuroImage: Clinical, 2023; 37: 103355 DOI: 10.1016/j.nicl.2023.103355

Feature

Feeling like we have a degree of control increases tolerance to pain. But for those with fibromyalgia, this doesn’t work and a recent study yielded results that may explain why.

Fibromyalgia is a mysterious chronic pain disorder that is difficult to treat—it was added to the World Health Organization’s catalogue in 1994 so there is much for science yet to discover about this illness. Its causes are also still largely unclarified.

A study conducted by the team at the Clinic for Psychosomatic Medicine and Psychotherapy at Ruhr University Bochum, Germany, provides evidence that certain brain areas involved in processing pain don’t function normally in fibromyalgia patients. In healthy people, they ensure that pain that we can control is easier to bear. The study found that these brain areas showed altered activity in patients with fibromyalgia.

The degree to which we experience pain and the restriction caused by it depend largely on how we perceive it. If we have the feeling that we can control the pain and shut it down ourselves, for example, we will tolerate it better than if we feel at its mercy. “For people with chronic pain, the inability to control repeated attacks of pain is one of the most significant causes of impaired quality of life,” explained Benjamin Mosch, lead author of the study. “And yet, the underlying neural mechanisms have so far mainly been studied in healthy controls.”

In the current study, the team compared two female cohorts: 21 healthy participants and 23 fibromyalgia patients. Both groups were exposed to heat pain while their brain activities were monitored by functional magnetic resonance imaging. In one experimental run, the participants were able to stop the pain stimulus themselves. In another run, a computer controlled the start and end of the stimulus. “We kept the duration of the stimuli terminated by the computer the same on average as the stimuli terminated by the test subjects,” said team leader Prof. Martin Diers.

When women in the healthy control group were able to terminate the pain stimulus themselves, a number of mainly frontal brain areas were activated that seem to play an important role in modulating pain. This observation is consistent with previous studies involving healthy subjects. “Interestingly, however, we didn’t detect any such activations in our patient group,” commented Diers. “This can serve as evidence for impaired pain processing among patients with fibromyalgia. It indicates that the cognitive resources for dealing with acute pain are impaired in these patients.”

References:

Mosch B, et al. “Neural correlates of control over pain in fibromyalgia patients.” NeuroImage: Clinical, 2023; 37: 103355 DOI: 10.1016/j.nicl.2023.103355


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