Nerve Stimulation Might Ease Fibromyalgia Pain

Small early study saw improvement in patients' quality of life

By Maureen Salamon

HealthDay Reporter

MONDAY, June 10 (HealthDay News) -- An implanted device that zaps the nerves at the nape of the neck -- shown effective in treating some people with migraines -- may also help ease the ache of fibromyalgia, an ailment that causes widespread body pain and tenderness.

A Belgian scientist treated small numbers of fibromyalgia patients with "occipital nerve stimulation," which rouses the occipital nerves just beneath the skin at the back of the neck using an implanted device. Dr. Mark Plazier found that pain scores dropped for 20 of 25 patients using this device over six months and their quality of life improved significantly.

"There are only a few treatment options [for fibromyalgia] right now and the response to treatment is far from 100 percent, which implies there are a lot of patients still looking for help to get a better life. This treatment might be an excellent option for them," said Plazier, a neurosurgeon at University Hospital Antwerp. But, "it is difficult to determine the impact of these findings on fibromyalgia patients, since larger trials ... are necessary."

Plazier is to present his research this week at a meeting of the International Neuromodulation Society, in Berlin. Neuromodulation is a group of therapies that use medical devices to relieve symptoms or restore abilities by altering nerve system function.

Research presented at scientific conferences has not typically been peer-reviewed or published and is considered preliminary.

Fibromyalgia is thought to affect about 5 million American adults -- most of them women -- according to the U.S. National Institutes of Health. The cause of the disorder, which can also involve sleep problems, anxiety and depression, is unknown and it can be difficult to treat.

Plazier also presented a separate study on six fibromyalgia patients using PET scan images to visualize brain changes from occipital nerve stimulation treatment. It suggested that the nerve stimulation changes activity in the limbic system, a brain region that helps determine pain perception.

"In fibromyalgia, we see that there is a hypervigilance to pain, so patients are more sensitive to pain and more aware of it," Plazier said. "They also have high scores on questionnaires concerning catastrophizing behavior, which implies the high impact of pain on their lives."

"During [occipital nerve] stimulation we see differences in brain activity on PET scans in regions involved in pain," he added. "This all might suggest that we are influencing a cerebral system and might even turn it back to 'normal' perception."

Study participants didn't find the nerve-zapping treatment to be painful, Plazier noted. The occipital nerve stimulation device is implanted during a brief surgery using general anesthesia, he said, and postoperative pain is normal but not extreme.

Dr. Patrick Wood, director of the fibromyalgia clinic at Madison River Oaks Medical Center in Canton, Miss., called the studied "interesting and promising" but said additional research is necessary before treatment with occipital nerve stimulation -- which may cost around $10,000 -- could become mainstream for fibromyalgia patients.

"It's mostly used in headaches, and even in the headache realm it's still considered experimental," Wood said. "It would be nice to have expanded data here that would indicate there's something worth banking on and putting our hopes on. It's promising, but more work needs to be done before the average patient can consider it."

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Weather Doesn't Trigger Fibromyalgia Symptoms, Study Finds

But some patients still may be more sensitive than others

By Mary Elizabeth Dallas

HealthDay Reporter

TUESDAY, June 4 (HealthDay News) -- Although some people with fibromyalgia are sensitive to changes in temperature, sunshine and precipitation, new research shows that weather conditions do not affect the pain or fatigue associated with this chronic condition.

"Our analyses provide more evidence against, than in support of, the daily influence of weather on fibromyalgia pain and fatigue," said study first author Ercolie Bossema from Utrecht University in the Netherlands.

The study, published in the journal Arthritis Care & Research, involved nearly 350 women with fibromyalgia, a chronic syndrome that causes unexplained pain, fatigue, headaches and sleep disturbances. The women were 47 years old, on average, and had been diagnosed almost two years earlier. They were asked about symptoms of pain and fatigue over the course of 28 days, during which time the researchers also recorded weather conditions, including outside temperature, sunshine duration, precipitation, atmospheric pressure and relative humidity, as reported by the Royal Netherlands Meteorological Institute.

Changes in weather showed a significant but small effect on pain or fatigue symptoms for 10 percent of cases. Significant, small differences between patients' responses to weather also were found in 20 percent of cases.

The researchers said differences among the women's response to weather conditions did not appear linked to functional or mental health status, demographics or seasonal or weather-related variations.

In the United States, 5 million people have fibromyalgia, many more of them women than men. Although the cause of this chronic pain syndrome is unclear, previous studies have suggested some people with fibromyalgia are more sensitive to certain stimuli. Up to 92 percent of people with this condition report a worsening of symptoms because of weather conditions.

"Previous research has investigated weather conditions and changes in fibromyalgia symptoms, but an association remains unclear," Bossema said in a journal news release.

The study's authors said future research on this issue should include more patient characteristics, such as personality traits and beliefs about chronic pain, in order to explain individual differences in weather sensitivity.

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