Small Fiber Neuropathy

Recently there has been more written about fibromyalgia being related to something called “small fiber neuropathy.”

A study reported in a medical journal called ‘Pain’ was published in November, 2013. The authors compared skin biopsies of fibromyalgia and normal control subjects and found that 41% of the skin biopsies in the fibromyalgia patients were positive for small fiber polynueropathy. The study also discussed how some patients also had dysimmune markers demonstrating increased inflammation. There is other research relating this polyneuropathy to pre-diabetic dysfunctions.

The implication has been that this neuropathy causes the pain of fibromyalgia. I think it is more likely that this neuropathy represents an injury to these nerves that is severe enough to be documented in some fibromyalgia patients, but that it does not cause the fibromyalgia.

There is other information that helps us understand this issue in a different way.
Fascia is the silent network of strings and sheets of tissue that holds our bodies together. Fascia surrounds and goes through every muscle, organ, and bone in our bodies. The small fiber nerves these articles refer to are within the fascia, everywhere in our bodies. They give information to our brain and communicate directly with the autonomic nervous system and also with the emotional nervous system. These nerves are very good at sensing small differences in pressure, shear, and strain between the layers of fascia. They are responsible for the sensations of pain, temperature, itch, tick, sensual touch, sexual arousal, distension of bladder, hunger, thirst, and even air hunger. These nerves are also related to providing us with emotional awareness.

The cells called fibroblasts that make up much of our fascia are capable of producing inflammatory chemicals that cause us to feel pain. This inflammation may cause injury to the small nerve endings, and researchers may be identifying this as a small fiber polyneuropathy.

The inflammatory machinery in the cells of our fascia and nervous system fascia is turned on by injury, and abnormally by inflammatory foods. When our fibromyalgia patients stop eating inflammatory foods, much of their pain goes away with this abnormal inflammation. This is consistent with the idea that our bodies have a tremendous ability to heal….and it is important for doctors and health care professionals to teach people how to get out of their body’s way so that it can do the healing it needs and knows how to do.

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