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Dr. P - autonomic testing and link to FB?
scwling posted:
Hello Dr. P, looking for some insight you may have. I've been recommended to go for autonomic testing as related to all the pain/etc. issues I've had for the past couple of years. (Note - I've not ever been formally diagnosed as having fibromyalgia, however a couple of docs - including the rhematologist I recently saw - have alluded to it since nothing else can be diagnosed.)

Do you have any experience with relationship to autonomic testing and link to FB? Any insight, etc. you can provide would be helpful.

Scott, Neenah WI
Mark Pellegrino, MD responded:
Hi Scott,

There is a known link between FM and autonomic nerve dysfunction or dysautonomia. Some of the more well known associated conditions thought to be due to the dyfunctional autonomics include IBS, irritable bladder, anxiety disorder, migraines, and near-fainting spells (near-syncope). Rapid heart rate, fatigue, poor sleep, temperature changes and many other of our fibro symptoms are linked to our dysfunctional autonomic nerves.

One test used to measure for dysautonomia is tilt-table testing, a way to measure the autonomic abnormalities in the blood pressure and pulse in response to tilting "stresses."

The reason for the dyautonomia in FM: it's felt to be part of the hypersensitive nerves and central sensitization that occurs in FM. Autonomic nerves, especially the sympathetics are closely connected to the pain and sensory processing nerves so anything the activates the pain will activate the sympathetics as well. Thus,we don't just feel pain, we feel sweaty, anxious, tachy, short of breath, crampy, fatigued etc etc etc!

Hope this helps.

Dr. P

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