How femtech is helping fibromyalgia patients

Fibromyalgia is a poorly understood condition causing chronic, widespread pain in sufferers – the majority of which are women.

According to the NHS, the condition affects around seven times more women than men, and typically starts between the ages of 30 and 50, although it can affect any age.

It is not known what causes it, although theories suggest its onset often coincides with periods of stress, such as bereavement, injury or giving birth. There is also thought to be a hereditary aspect too.

The main symptom is generalised pain, which may be accompanied by extreme tiredness, muscle stiffness, difficulty sleeping and problems with memory and concentration, which is known as fibro-fog.

There is no cure for fibromyalgia, rather a number of ways of treating the symptoms, including anti-depressants, painkillers and lifestyle changes.

However, with advances in technology that focuses on female-specific conditions, known as femtech, could there be more solutions on the horizon?

Digital pain relief

Pain is often the most debilitating symptom of fibromyalgia, and, understandably, many women don’t want to be wholly reliant on painkillers, which can themselves bring unwanted side effects.

A number of developments in the femtech world have led to the creation of digital solutions, such as NeuroMetrix’s Quell device, which was last year granted breakthrough device designation by the US Food and Drug Administration (FDA) to treat the symptoms of fibromyalgia in adults.

The device uses transcutaneous electrical nerve stimulator (TENS) technology to offer symptomatic relief and management of chronic pain in the lower extremities.

Designed for over-the-counter use, Quell is a non-invasive, wearable device which is enabled by a tailored microchip that offers flexible, accurate nerve stimulation at increased power, providing targeted pain relief without the need for drugs.

Digital therapy

Another treatment that is often offered to fibromyalgia patients alongside medication is some form of talking therapy, but these can be inconvenient to access and attend.

Another technology that received Breakthrough Device Designation from the FDA last year is Swing Therapeutics’ programme of digital therapy.

It offers simple-to-use, daily digital therapeutic lessons and interactive exercises to help patients apply well-established principles to their own specific circumstances and symptoms, giving them the tools to manage their condition.

The self-guided program is designed to foster patients’ understanding and acceptance of their symptoms, while teaching powerful condition management skills via acceptance and commitment therapy (ACT). The program, which is currently being researched and trialled, also incorporates a tool to help users manage their symptom flare-ups – a common occurrence with fibromyalgia.

Symptom trackers

While not designed to cure or manage pain, symptom trackers can help fibromyalgia sufferers by noticing their triggers or any patterns to their flare-ups.

Taking a more careful note of how the condition affects them can help patients learn how best to manage the condition, minimising the pain and the disruption.

There are a variety of symptom tracking apps on the market, including Manage My Pain and PainScale, and all work in a broadly similar way.

While not specifically for fibromyalgia, PainScale, which was created with advice from doctors and chronic pain patients, tracks and organises all symptoms.

It also provides personalised pain management education, with more than 800 articles, health tips, exercises, and information about a whole range of programmes and treatment options. It can also be used to log and track pain so patients can identify triggers, helping them manage their condition.

Similarly, Manage My Pain helps patients keep detailed notes on their symptoms, which not only put them in more control of the condition, but can also help when seeking medical advice or treatment.

Conclusive proof

Because fibromyalgia is so widely misunderstood and under-researched, with vague if debilitating symptoms, there has traditionally been a tendency to dismiss it – especially bearing in mind long-standing issues with medical practitioners dismissing women’s pain.

However, in recent years, AI (artificial intelligence) and machine learning have been used to prove the condition exists – and may have a neurological cause.

In 2017, researchers used machine learning to distinguish the brain scans of those with fibromyalgia from those without, and had 93 per cent accuracy.

In the study, MRI machines were used to capture images of the brain signals of 37 fibromyalgia patients and 35 healthy people as a control. All participants had pressure applied to their right thumbnail to cause “severe but tolerable pain,” explained the researchers in their paper, which was published in the journal Pain.

Those with fibromyalgia were seen on the MRI to experience more pain than the healthy controls, according to a neurological marker of physical pain, as well as showing different activity in the insula area of the brain, related to sensory integration, and the medial prefrontal cortex, which is important for emotional regulation.

These different neurological responses created a brain signature for fibromyalgia patients, which a machine-learning algorithm was then able to use to predict which brain scans showed fibromyalgia and which did not.

While the research did not attempt to study the cause of the pain, for many fibromyalgia sufferers, simply knowing that it was real was cause for relief.