Fw: Some pain may be caused by brain malfunction, researchers report fibromyalgia

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Sent: Sunday, October 27, 2002 11:19 PM

Subject: Some pain may be caused by brain malfunction, researchers report fibromyalgia

Some pain may be caused by brain malfunction, researchers reportNEW ORLEANS (October 27, 2002) - Lower back pain with no immediate physical cause could be the result of malfunctioning pain pathways in the brain, University of Michigan researchers reported Sunday. The same situation could be true for fibromyalgia pain and other forms of mysterious pain, they added. "These patients often get criticized for supposedly imagining their pain," lead investigator Gracely, professor of rheumatology at the University of Michigan School of Medicine in Ann Arbor, told United Press International. "This research indicated that these forms of pain, and perhaps many others, are rooted in disorders in the brain which are as real physiologically as an injured back." Gracely and colleagues presented their research at the annual meeting of the American College of Rheumatology. They recruited 15 subjects with lower-back pain and with no physical cause, such as muscle, joint or bone injury. They also recruited 15 fibromyalgia patients and 15 normal control subjects. The investigators used a super-fast form of MRI brain imaging, called functional MRI or fMRI. "The fMRI technology allowed us to see the neurobiology behind the pain reported by patients with fibromyalgia and lower-back pain, both of which usually appear to have no physical cause at the site of pain," Gracely said. All of the subjects underwent fMRI scanning while having a device apply pulsing pressure to the base of their left thumbnail. The variable pressure included painful and non-painful levels. The researchers found mild pressure caused subjects with lower-back pain and fibromyalgia to report significant pain, while control subjects tolerated the same pressure with little pain. In the lower-back pain and fibromyalgia subjects, mild pressure caused brain responses in areas that process the sensation of pain, responses that did not occur in the control subjects until pressure was raised substantially. All subjects showed increased activity in eight areas of the brain, but the lower-back pain subjects showed no increased activity in two areas that were active in both the fibromyalgia and control subjects. However, the fibromyalgia subjects showed increased activation in two other areas not active in back pain patients and healthy subjects. The study suggests lower-back pain patients have developed an enhanced pain response in some brain regions and diminished response in others, the researchers said, adding the study offers the first objective method for correlating lower-back pain to unique brain activities at the precise moment of adverse feeling. "So lower-back pain is real and fibromyalgia pain is real," Derby, spokeswoman and director of public policy and education at the National Fibromyalgia Association in Orange, Calif., told UPI. "This impressive research confirms that both kinds of pain (create) an event in the body. The source of pain may be in the brain, but it is nevertheless real and can become as disabling as a serious physical injury," she added. The research eventually might lead to better treatments for lower back pain and fibromyalgia, by pointing future researchers toward certain brain regions where pain-inducing disorders could be located, Gracely noted. Lower back pain is common, especially among heavy and sedentary people and those whose work is physically demanding. Lower back pain and problems stemming from it are a frequent cause of lost work days in adults under the age of 45, ranking second only to the common cold. The study was supported in part by the National Fibromyalgia Research Association, the U.S. Army and the National Institutes of Health.

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