INSITE: Measuring nociceptor activity in people with chronic pain using microneurography

A tiny electrode inserted through the skin into a nerve in the arm or leg will record the electrical activity of pain-sensing nerves in people with fibromyalgia and other chronic pain conditions. More than a third of UK adults live with chronic pain, and one in 20 has fibromyalgia, yet doctors do not know why these patients feel pain. Standard medications often fail. This study aims to close that gap by directly measuring whether patients’ pain stems from overactive nociceptors—the specialised nerves that detect tissue damage. Researchers will first test sensitivity to heat, cold, and pressure, then insert a microneurography electrode to record nerve signals, alongside patient questionnaires. If the research succeeds, it will reveal whether fibromyalgia pain originates from peripheral nerves or from central processing in the brain and spinal cord. That distinction is critical: it could guide development of targeted treatments that quiet overactive nerves rather than relying on trial-and-error prescribing. It would also give clinicians a concrete explanation to offer patients, replacing uncertainty with a biological basis for their pain. Without this work, the opportunity to understand and improve care for millions of people will be lost.