Fibromyalgia – a chronic, musculoskeletal syndrome characterized by fatigue, sleep disturbances and cognitive difficulty, along with widespread muscle and joint pain – brings some clients to massage.

New research indicates that a disruption of brain signals for reward and punishment contributes to increased pain sensitivity, known as hyperalgesia, in fibromyalgia patients.

“In patients with fibromyalgia there is an alteration in the central nervous system pain processing and a poor response to topical pain treatments, trigger point injections and opioids,” said lead author Dr. Marco Loggia from Massachusetts General Hospital and Harvard Medical School in Boston, in a press release from Wiley, which published the research. “Our study examines the disruption of brain function involved in the individual experience of pain anticipation and pain relief.”

Thirty-one patients with fibromyalgia and 14 healthy controls participated in this study. “Functional magnetic resonance imaging (MRI) and cuff pressure pain stimuli on the leg were performed on all subjects,” the press release stated. “During the MRI, participants received visual cues alerting them of impending pain onset (pain anticipation) and pain offset (relief anticipation).”

Results showed:

• during pain anticipation and relief, fibromyalgia patients displayed less robust response within brain regions involved in sensory, affective, cognitive and pain regulating processes.

• The ventral tegmental area (VTA)—a group of neurons in the center of the brain involved in the processing of reward and punishment—displayed activation during pain anticipation and stimulation, but deactivation during anticipation of relief in healthy controls.

• In contrast, VTA responses during periods of pain, and anticipation of pain and relief, in fibromyalgia patients were significantly reduced or inhibited.

The research was published in Arthritis & Rheumatis, published by Wiley

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