Research Update
study was limited to women, who
have over twice the occurrence
of fibromyalgia than men.
W
hat the team uncovered was
an enormous increase in
sensory nerve fibers at specific
sites within the blood vessels
of the skin in the palms of the
hands. These critical sites are
tiny muscular valves, called arteriole-venule (AV) shunts, which
form a direct connection between
arterioles and venules. The
discovered pathology involving
the nerve endings to the shunts
provides a logical explanation
not only for extreme tenderness
in the hands, but also for the
widespread deep pain and fatigue
symptomatic of fibromyalgia.
AV Shunts Are Like Thermostats in the Skin
T
o understand what
the scientists believe
is the nature of the problem affecting fibromyalgia patients, let’s think
about a problem that
most of us have experienced at one time or another with our cars. You
wake up in the morning.
It’s cold and damp. You
go out to start your car,
turn the key, and the engine sputters and runs a
bit rough. You back out
of your driveway and
the engines stalls, and
then again at a stop
sign. It finally warms up
and starts running more
smoothly. As you go
about your errands, you
smell coolant fluid and
notice that the engine
temperature warning light is on.
The engine is now overheating.
What’s wrong with your car? You
take it to a mechanic who tells you
that you need a new thermostate?
What’s a thermostat?
H
ere’s the problem. Your car
has a cooling system with
hoses that run between the engine
and a large, flat honey-combed
part called the radiator that is
located at the front of the engine
compartment. The coolant circulates between the engine, which
gets hot, and the radiator which
spreads the coolant out into thin
tubes where the air flowing over
the radiator carries away the heat.
The coolant system has a pump
to circulate the coolant between
the engine and the radiator. The
12 Fibromyalgia & Chronic Pain
Life
radiator also has a fan, so if the
coolant gets very hot, it increases
the air flow to facilitate the cooling process. However, when you
start your engine, it won’t run
properly until it warms up, so you
don’t want the coolant to go to
the radiator right away.
T
he thermostat is a valve that
regulates the f low of coolant between the engine and the
radiator so everything functions
properly. When the engine is
cold, the thermostat keeps the
coolant in the engine until it
warms up. Then the thermostat
allows the coolant to go to the
radiator so the engine doesn’t
become too hot. Finally, the
thermostat balances the f low
between the engine and the ra-
Winter 2014
diator to maintain just the right
operating temperature whether
you are going downhill when the
engine doesn’t have to work very
hard or uphill when the engine is
straining.
A
nother factor that influences
the operation of the thermostat, is whether it is cold or hot
outside. In other words, the engine isn’t the only source of heat,
and the radiator isn’t the only
source of cooling. On a hot day,
much more coolant has to be sent
to the radiator to compensate for
the high air temperature, and it
is much more likely that the radiator fan will turn on to increase
the air flow. On a cold day, it will
be more important to keep heat
in the engine. Simple, huh?