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Great points, Bruce and CB.

While I disown any connection to Forest laboratories, I see this study as lending evidence to Dr. Sarno's theories. He has always said that TMS is caused by restriction in blood flow. The reduced blood flow to tissues such as muscle, nerve, and tendon lead to those tissue not having enough oxygen and becoming very painful. Given that fibromyalgia is clearly very severe TMS, to validate Dr. Sarno's beliefs, we should be examining fibromyalgia patients for changes in tissues that regulate blood flow.

Not surprisingly, that's exactly what this paper finds. It finds that tiny little blood vessels that shunt blood around have excessive numbers of nerve fibers around them. The article doesn't attempt to explain how all of those nerve fibers got there, but suppose that someone has extreme TMS, and the unconscious brain is constantly sending signals all over the body to redirect blood flow. We know from brain plasticity that nerve tissue is constantly adapting to its circumstances. If the brain is constantly sending signals to the shunts in the hands of patients with fibromyalgia to redirect blood, then perhaps this causes an increase in nerve fibers in the tiny AV shunts that redirect the blood. I don't know if nerves in the skin are plastic to that degree, but what else would be causing this?

Being typically cautious, the article doesn't speculate, which is wise. I would certainly not speculate myself, but I just want to point out that this data could easily fit in to Dr. Sarno's theories.

I'm lucky to currently have access to a research library, so I downloaded the paper. It's very dense, but the following sentence caught my eye:

Deep tissue ischemia? Ischemia implies lack of blood flow, so that is pure Sarno. Regarding central nervous system responsiveness, I think that we turn to Dr. Schubiner's contributions to understand that. In an interview I did with him, he wrote, "If you combine central sensitization with the psychological mechanisms that I discussed in the last question, I think you have a pretty good model for [TMS]."

Another quote:

Dr. Sarno always explained the mechanism of TMS as being through the autonomic nervous system (ANS). Half of the ANS is involved with triggering the fight or flight response and is called the sympathetic nervous system (SNS). The above sentence says that there are excess sympathetic nerves going to the little gates that control blood flow.

This is just one study and I think it will be decades before anyone really knows what is going on. Dr. Sarno is very clear about the limitations on current knowledge regarding the mechanisms of TMS. Indeed, he's quite comfortable with the question marks that still remain, even referring to a "black box" at one point. To this, I must add that I, of course, am not a doctor and have only read a small part of it. But I do think it is very interesting to note that there are a wide variety of ways that any result can be interpreted.

These researchers took little slices of skin on the pinky side of the hand and on the chest of some fibromyalgia patients and found that there were lots of nerve fibers in the little gates that control blood flow in the skin from the hand. Who knows what other parts of the body might have additional nerve fibers that are related to blood flow. Dr. Sarno identified muscle, nerve, and connective tissue as the main tissues that are affected by TMS. It could very well be that they also have additional nerve fibers as well and that those nerve fibers are cutting off blood flow in order to create the symptoms of TMS. We simply don't know. All that we really know is that people who read Dr. Sarno's books, who have struggled for years and years tend to get better.

It's exciting to see. Thanks for sharing it, Dr. Z!