The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) sponsors research that will improve scientists’ understanding of the specific problems that cause or accompany fibromyalgia, in turn helping them develop better ways to diagnose, treat, and prevent this syndrome.
The research on fibromyalgia supported by the NIAMS covers a broad spectrum, ranging from basic laboratory research to studies of medications and interventions designed to encourage behaviors that reduce pain and change behaviors that worsen or perpetuate pain.
Following are descriptions of some of the promising research now being conducted:
Understanding pain. Research suggests that fibromyalgia is caused by a problem in how the body processes pain, or more precisely, a hypersensitivity to stimuli that normally are not painful. Therefore, several National Institutes of Health (NIH)-supported researchers are focusing on ways the body processes pain to better understand why people with fibromyalgia have increased pain sensitivity. These studies include:
- The establishment of a tissue bank of brain and spinal cord tissue to study fibromyalgia and to determine the extent to which chronic pain in fibromyalgia patients is associated with the activation of cells in the nervous system and the production of chemical messengers, called cytokines, that regulate immune cell function.
- The use of imaging methods to evaluate the status of central nervous system responses in patients diagnosed with fibromyalgia compared with those diagnosed with another chronic pain disorder and pain-free controls.
- An investigation to understand how the activation of immune cells from peripheral and central nervous system sources trigger a cascade of events leading to the activation of nerve cells, chronic pain, and the dysregulation of the effects of analgesic drugs against pain.
- An intensive evaluation of twins in which one of the pair has chronic widespread pain and the other does not, along with twins in which neither of the pair has chronic pain, to help researchers assess physiological similarities and differences in those with and without chronic pain and whether those differences are caused by genetics or environment.
- A study examining the use of cognitive behavioral therapy in pain patients, which researchers hope will advance their knowledge of the role of psychological factors in chronic pain as well as a new treatment option for fibromyalgia.
- The Patient-Reported Outcomes Measurement Information System (PROMIS) initiative. The PROMIS initiative is researching and developing new ways to measure patient-reported outcomes (PROs), such as pain, fatigue, physical functioning, emotional distress, and social role participation that have a major impact on quality of life across a variety of chronic diseases. The goal of this initiative is to improve the reporting and quantification of changes in PROs. The NIAMS supports an effort to develop PROMIS specifically for use in patients with fibromyalgia.
Improving Symptoms. A better understanding of fibromyalgia and the mechanisms involved in chronic pain are enabling researchers to find effective treatments for it. Some of the most promising lines of research in this area include the following:
- Increasing exercise. Although fibromyalgia is often associated with fatigue that makes exercise difficult, regular exercise has been shown to be one of the most beneficial treatments for the condition. Researchers are trying to determine whether increasing lifestyle physical activity (that is, adding more exercise such as walking up stairs instead of taking the elevator) throughout the day produces similar benefits to exercise for fibromyalgia, improving symptoms such as pain, fatigue, and tenderness. Scientists are also examining the potential mechanisms by which lifestyle physical activity might influence symptoms. Other research supported by the NIAMS is examining the effectiveness of a simplified form of Tai Chi on pain and other measures such as sleep quality, fatigue, anxiety, and depression.
NIAMS-supported research is also examining ways to help people maintain helpful exercise programs. Because many people with fibromyalgia associate increased exercise with increased pain, doctors and therapists often have a difficult time getting patients to stick with their exercise program. The new research is examining patients’ fears that cause them to avoid exercise as well as behavioral therapies to reduce fears and help them maintain exercise.
- Improving sleep. Researchers supported by the NIAMS are investigating ways to improve sleep for people with fibromyalgia whose sleep problems persist despite treatment with medications. One team has observed that fibromyalgia patients with persistent sleep problems share characteristics with people who have sleep-disordered breathing—a group of disorders, the most common of which is the obstructive sleep apnea, characterized by pauses in breathing during sleep. These researchers are studying whether continuous positive airway pressure (CPAP, a therapy administered by a machine that increases air pressure in the throat to hold it open during sleep) might improve the symptoms of fibromyalgia.
Other groups of researchers are examining the link between sleep disturbance and chronic pain in fibromyalgia and are studying whether behavioral therapy for insomnia might improve fibromyalgia symptoms.
More information on research is available from the following resources:
- National Institutes of Health (NIH) Clinical Research Trials and You was designed to help people learn more about clinical trials, why they matter, and how to participate. Visitors to the website will find information about the basics of participating in a clinical trial, first-hand stories from clinical trial volunteers, explanations from researchers, and links on how to search for a trial or enroll in a research-matching program.
- ClinicalTrials.gov offers up-to-date information for locating federally and privately supported clinical trials for a wide range of diseases and conditions.
- NIH RePORTER is an electronic tool that allows users to search a repository of both intramural and extramural NIH-funded research projects from the past 25 years and access publications (since 1985) and patents resulting from NIH funding.
- PubMed is a free service of the U.S. National Library of Medicine that lets you search millions of journal citations and abstracts in the fields of medicine, nursing, dentistry, veterinary medicine, the health care system, and preclinical sciences.