Fibromyalgia is what's called an "invisible" condition. You and others may not be able to see your symptoms, but they really exist. What's more, your fibromyalgia symptoms share a connection, which is due, in part, to issues with your central nervous system.
Central amplification is when your body's ability to sense pain might not be working the way it should, making you extremely sensitive to all types of pain. This can result in a host of interconnected symptoms. It's also possible that the receptors inside your brain "hang onto" a memory of pain even after it stops. That could make you feel pain or discomfort.
Still, scientists can actually see how people with fibromyalgia process pain differently in brain imaging scans. Thus, doctors have to keep all this in mind when they try to manage your specific symptoms.
Fibromyalgia Affects Your Entire Body
Your fibromyalgia symptoms may not be constant. They can come and go, which also makes them harder to pin down and treat. They may also overlap with symptoms of other conditions, making it hard to distinguish them from other conditions.
While different for everyone, the common fibromyalgia symptoms include:
Chronic body pain
It might not be the same all the time. It could be stabbing or shooting pain, or you could have a dull ache all over your body. Your pain may come and go, and it could get worse because of:
- Cold weather
- Humidity
- Poor sleep
- Too much or not enough exercise
- Anxiety
- Stress
Sore muscles
This can be confusing because you may feel like you pulled or strained a muscle. Chemical changes in your muscles catch the attention of your nerves, which then notify your brain. Your brain then labels them as "pain."
Fatigue
Feeling bone-tired all the time may be a result of not being able to get to sleep or stay asleep. Many people with fibromyalgia also have trouble staying in the deepest stage of sleep, non-REM stage 3 (slow-wave/delta) sleep. Abnormal bursts of brain activity may keep pulling you out of it, so you never get all the rest that your body needs.
Brain fog
You might hear this called "fibro fog." You could find it hard to focus, follow a conversation, or remember a word, although it's on the tip of your tongue. One theory for fibro fog is that your brain gets overwhelmed because of all the pain signals it receives.
Headaches
Although they're a common symptom of fibromyalgia, typical headache treatments may not help. That's because the pain you feel may be due to tender areas in your muscles called myofascial trigger points (MTPs). Everyone has them, but when you have fibromyalgia, your MTPs are "switched on." They irritate nearby nerve endings and radiate pain.
MTPs signal to your central nervous system that something's wrong. The opposite is true, too. When your central nervous system isn't working well, your MTPs may also get activated and hurt.
MTPs are throughout your body, so they can cause pain in different muscles. Tender MTPs in your neck and shoulders are linked to headaches.
Digestive issues, like bloating or constipation
Your gastrointestinal (GI) tract is covered with sensitive nerve cells that both send and receive "messages" with your nervous system. These cells can be affected by your microbiome, the "good" and "bad" bacteria that naturally live in your gut. If your microbiome gets out of balance, your immune system can release special chemicals called cytokines into your bloodstream. Cytokines can increase pain and inflammation. And not just in your gut, but throughout your body, including your brain.
Research shows that a gut imbalance is more likely when you have fibromyalgia.
Sensitivity to light, noise, smells, and temperature
If you suddenly get ringing or buzzing in your ears or feel a headache coming on from a strong perfume, your brain may be having an overreaction to the data it's taking in through your senses. That can cause your nervous system and other parts of your body to go on "urgent" alert by mistake.
Numbness, tingling, or feeling "pins and needles"
Burning or shooting pains in your hands or feet usually mean that you've damaged nerves outside your brain and spinal cord. But when you have fibromyalgia, your doctor won't find anything wrong if they do a nerve conduction test or take a biopsy. That's because this symptom is due to your central nervous system making a mistake in how it processes pain.
Abnormal sensitivity to pain
If you're extremely sensitive to touch, wearing soft clothes, shaking someone's hand, or going from outdoor heat to air conditioning can feel painful.
The reason appears to lie in your central nervous system. When it's working the way it should, it learns from past sensory data. For instance, if you get burned by touching a hot stove, the pain you feel will warn you not to do it again. Fibromyalgia may cause your nervous system to misread the data it gets and prompt the wrong response.
Skin issues like rashes and itching
When researchers have looked at skin samples of people with fibromyalgia, they've found high amounts of mast cells. These are immune cells that alert your body to possible threats like germs, but sometimes, they turn "on" by mistake. Mast cells can also play a role in pain and headaches.
Restless legs syndrome (RLS)
This is a strong urge to move your legs because of an itching, aching, or throbbing feeling. It gets worse at night, so you may find it hard to sleep well. RLS is believed to be caused when an area of your brain that controls movement doesn't function well.
Mental health issues
Anxiety is common when you have fibromyalgia. You could also have depression or posttraumatic stress disorder (PTSD). Experts are still trying to figure out why. Chronic pain and lack of sleep caused by fibromyalgia may affect your mental health. Or the same brain transmitters that trigger fibromyalgia could impact your mood.
Conditions That Overlap With Fibromyalgia
When you have fibromyalgia, you're also more likely to have conditions with symptoms that can overlap. These include:
- Migraine
- Chronic fatigue syndrome
- Temporomandibular disorder (TMD)
- Interstitial cystitis (painful bladder)
- Irritable bowel syndrome (IBS)
- Postural orthostatic tachycardia syndrome (POTS)
- Post-COVID syndrome (long COVID)
Treating Your Fibromyalgia Symptoms
Your doctor has a lot of work to do to understand the pain you're having and where it's coming from. That often means ruling out other conditions, which can take time. For instance, if you have intense, ongoing muscle or soft tissue pain, your doctor may want to do imaging tests to make sure that you don't have an injury or another medical condition.
There's no cure for fibromyalgia, so your doctor will focus on managing your different symptoms. Treatment for your fibromyalgia symptoms could include:
Medication. Your doctor could ask you to try a medication that doesn't just work on one part of your body, but directly affects your brain. That can help relieve more than one symptom. But all medications can cause side effects. Some of these, like brain fog or an upset stomach, might overlap with the fibromyalgia symptoms that you're trying to treat.
Lifestyle changes. For instance, your doctor might suggest that you follow a certain eating plan, like the Mediterranean or FODMAP diet, which could help with digestive issues.
Exercise. Over time, physical activity can help adjust how your central nervous system regulates pain, but it's important not to overdo it. Too much exercise can cause your fibromyalgia to worsen. Your doctor or a physical therapist can help you choose types of exercise that target your specific symptoms. For instance, yoga may help reduce brain fog and pain and improve sleep.
Mental health therapy. Cognitive behavioral therapy (CBT) is a type of talk therapy that helps you become aware of negative thought patterns so you can learn to change them. It could help you learn to better manage your fibromyalgia pain.
Other therapies. Some people with fibromyalgia find that their symptoms improve with complementary (nonmedical) therapies, like acupuncture, hypnosis, or massage. But check with your doctor before you try these.
Fibromyalgia is a lifelong condition, but your symptoms could get better over time. Trying to stay positive and learning new ways to cope will be key. See your doctor regularly to let them know how you're doing and when you need more support.
Show Sources
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