--that many people over the years who have been diagnosed with "fibromyalgia" actually have as yet undetected small-fiber neuropathies, since skin biopsy is still not a test that is widely available (or ven known about by a good number of physicians).

Fibro did become a sort of "catch all" diagnosis for patients who came in and reported severe pain that seemed to have no direct physcial basis. But I had always thought there was some confusion with those who mayhave acutally had neuropathies but were not skilled in describing the exact nature of the pain they were experiencing--neurologicla pain IS difficult to describe, especially for those who have not experienced it before--AND there are many doctors not skilled in listening to what their patients were trying to describe and/or solciting more information from them.

I'm most interested now in the nerve root theory of fibro--there is a category of nerve dysfunction, neuronopathy, that describes problems that stem from damage to the dorsal sensory ganglia (and is common in Sjogren's, by the way) and in which symptoms may be indistiguishable from that caused by damage to nerve fibers farther down the periphery:

http://neuromuscular.wustl.edu/antib...uron.html#sfsn

In neuronopathies, there seems to be an attack directly on the cell bodies of sensory neurons. This can, of course, cause degeneration of the axonal endings as well, which often shows up on skin biopsy as reduced fiber density. The catch, as Hopkins' Dr. Abhey Moghekar once described to me, is that while nerve fibers can regenerate under the right conditions if the cell body is intact, if the cell body dies that nerve is gone forever (though sometimes other intact nerve cells can frow fibers and take over the functions).

Could fibro involve a neurotransmitter imbalance at the dorsal nerve root/ganglia that oversensitizes to pain? That is an interesting question.