Diagnosis: A Gray Area

For the approximately 3 percent of the population who suffer from the contested condition fibromyalgia, the pain is very real. An understanding of just where the diffuse, often body-wide distress comes from has been elusive, but new research pins the tail on dopamine.

Researchers at Louisiana State University confirmed previous findings that patients with fibromyalgia have reduced gray-matter density in certain areas of the brain, and also found a correlation between those diminished brain regions and reduced levels of dopamine metabolism. Decreased activity of this neurotransmitter, which is generally associated with pleasure responses and reward pathways, may be causing the structural changes, and thus the fibromyalgia.

Lead author Patrick Wood says investigations into drugs used to treat fibromyalgia should focus more closely on dopamine. "Dopamine has a major role in pain control," he says.

Give It a Rest

There is no pharmaceutical intervention for fibromyalgia, and dopamine drugs may be a long way off. Fibromyalgia expert Fred Friedburg of Stony Brook University describes the cognitive-behavioral approach to treating the difficult condition.

• "There is a connection between stress, overactivity, and pain," Friedburg says. "The goal of cognitive-behavioral therapy is to achieve a balance between activity, rest, and leisure."
• Pare down your work and activity schedules; pay attention to your personal needs.
• Introduce stress reduction, low-level exercise, and pleasant activities that don't tire you out.