What’s True
A 2013 study published in Pain Medicine studied the hands of 24 female patients and discovered an excess number of specific nerves surrounding a specific kind of blood vessel, hinting at a possible physical and identifiable cause for the disease.
What’s False
The study is no longer new, despite its having been billed as such for the past five years, nor has it changed the prevailing scientific view about the disease, which most argue is caused by an heightened sensitization of the nervous system.
Since at least June 2013, a nearly identical article has appeared on a number of websites with the headline “Fibromyalgia Mystery Finally Solved!” These stories, which continue to appear online, begin with the same claim:
Fibromyalgia is is an enigmatic condition that disproportionately affects women; it is associated with clinically unexplained pain, potentially combined with other symptoms of unknown medical origin. As reported in a 2014 review paper in the Journal of the American Medical Association:
Before diving into the research claims made in this “fibromyalgia solved” brand of clickbait, it is important to mention that framing the issue as a debate between those who think the pain is “imaginary” and those who think it is “real” is an extremely reductive description of the medical hypotheses surrounding fibromyalgia, and, indeed, of pain itself.
The most common explanation for the symptoms that present as fibromyalgia in the scientific literature is a phenomenon dubbed “central sensitization”, in which the central nervous system (either through physical trauma or another cause) lowers its threshold for registering external signals as pain. As described in a 2009 review:
The most common explanation for the symptoms that present as fibromyalgia in the scientific literature is a phenomenon dubbed “central sensitization”, in which the central nervous system (either through physical trauma or another cause) lowers its threshold for registering external signals as pain. As described in a 2009 review:
The researchers, who were also associated with a biotech company (INTiDYN) that developed the imaging technique used in the study, analyzed biopsies from 24 female patients with fibromyalgia and compared them to a number of healthy control subjects. The authors found that there was a significant excess number of nerves around these shunts in the fibromyalgia patient’s hands. The senior author on the paper, Frank Rice, explained the potential significance of the findings in their press release:
Outside of providing an explanation for fibromyalgia pain, the authors suggest this mechanism could also relate to other symptoms commonly associated with the condition:
While the study is real, it was limited in its scope due to its low sample size. Further, it does not appear to have shifted the debate away from hypotheses that revolve primarily around central sensitization, despite claims that the mystery had been “solved”. A 2015 review on the condition released by the Mayo Clinic describes the state of the field:
While the study is real and their specific results are not in question, it was neither new as of 2017, nor did it substantively change the debate on the cause of fibromyalgia, much less “solve the mystery”. As such, we rank the claim as mostly false.
