Why Patients with Fibromyalgia and Related Pain Conditions may Feel Invisible
What is pain? Why do we feel it? What causes pain? Pain is a topic that has intrigued scientists and philosophers alike for centuries. With the advancement of medical knowledge and technology, we may be getting closer uncovering truths about puzzling chronic-pain conditions such as fibromyalgia.
Historical Perspectives of Pain
The ancient Greeks attributed pain sensations to the infiltration of evil spirits and later to an imbalance of fluid, or humors, in the body. Others believed pain to be a Godly punishment for sins. French philosopher Rene Descartes was the first to describe pain as a sensation transmitted from nerves to the brain; and as ‘mechanical’ rather than mystical.
Descartes was also influential in the Enlightenment era of the 18th century which saw a shift in thinking from superstition to reason (i.e. the establishment and verification of facts). This significant philosophical transition is also evident in modern medicine wherein the gold standard in medical treatment is commonly believed to be based in evidence-based reasoning. Unfortunately, a large reliance on reason may contribute to a reluctance to accept fibromyalgia-which is often associated with pain without any visible abnormalities- within the medical community. After all, if you can’t see something, how do you really know it exists?
Imaging Technologies Helping Scientists ‘See’ Fibromyalgia
Medical imaging technologies such as Magnetic Resonance Imaging (MRI) allow scientists and doctors to see the brain as well as areas of the brain that are activated in response to stimuli such as pressure, heat and cold. In a study of individuals with fibromyalgia, chronic lower back pain and a control group, it was found that individuals with chronic pain had five (5) ‘pain areas’ in the brain respond to a pressure stimulus as opposed to just one (1) in the healthy control group (Giesecke et al). Furthermore, the groups afflicted with chronic pain perceived a standard pressure stimulus to be more painful than the control group.
This study demonstrates the plight of chronic pain patients: they do not display readily visible sources of pain such as injury or inflammation, yet their pain responses are more pronounced than the average Jane or Joe. Future research is aiming to seek appropriate treatments for exaggerated pain responses in chronic pain syndromes.
Giesecke, T., Gracely, R.H., et al. Evidence of augmented central pain processing in idiopathic chronic low back pain. Arthritis and Rheumatism. Vol. 50, No. 2, February 2004, pp 613–623 DOI 10.1002/art.20063s