Martínez-Lavín, Manuel · Clinical rheumatology · 2021 · DOI
This article explores whether structures called dorsal root ganglia (DRG)—small nerve clusters along the spine—might be the main source of pain in fibromyalgia. These ganglia contain pain-sensing nerve cells and immune molecules that can become overactive. Recent evidence suggests that in some fibromyalgia patients, these nerve clusters show signs of damage and increased pain signaling.
For ME/CFS patients with comorbid fibromyalgia, this framework offers a potential biological explanation for widespread pain and suggests that small fiber nerve pathology may be a treatable target. Understanding DRG involvement could help researchers identify why some patients develop neuropathic pain after physical stressors and may open new therapeutic avenues beyond symptom management.
This perspective article does not prove that DRG dysfunction causes fibromyalgia—it presents correlational and mechanistic evidence that is largely suggestive. The study does not establish whether DRG pathology is a primary cause or a secondary consequence of fibromyalgia, nor does it demonstrate efficacy of any DRG-targeted treatment in humans. The findings in rodent stress models may not directly translate to human disease.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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Primary citation
Martínez-Lavín, Manuel (2021). Dorsal root ganglia: fibromyalgia pain factory?. Clinical rheumatology. https://doi.org/10.1007/s10067-020-05528-z
BibTeX
@article{mecfsatlas-martnez-lavn-2021-dorsal-root,
author = {Martínez-Lavín, Manuel},
title = {Dorsal root ganglia: fibromyalgia pain factory?},
journal = {Clinical rheumatology},
year = {2021},
doi = {10.1007/s10067-020-05528-z},
note = {PubMed: 33409721},
url = {https://www.mecfsatlas.com/evidence/martnez-lavn-2021-dorsal-root},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/martnez-lavn-2021-dorsal-root
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