Extreme Itch in Fibromyalgia and Chronic Fatigue Syndrome

That constant itch may be part of your fibromyalgia or myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

Neuropathic itch is a specific type of itch that stems from the nerves and brain, both of which are affected by these conditions. It can be severe and hard to stop.

Adding to this is a fibromyalgia pain type called allodynia, which can be triggered by touch or rubbing the skin. Scratching an itch can make the whole area scream with pain.

This article looks at possible reasons for the itch, what research shows, what might help, and what treatments are being studied.

Woman scratching itch
Maria Fuchs / Getty Images

Why Do You Itch?

One fibromyalgia survey found itchiness without a known cause in about 2% of people with the condition. However, researchers only reviewed symptoms that participants self-reported.

In other words, because many people don't know that itch is a fibromyalgia symptom, they may not have thought to mention it.

So far, researchers can't say for certain why these conditions involve an itch. They have started researching this symptom, though.

It's believed the itch comes from an abnormal nervous system. The immune system may also play a role.

Many people with these conditions have abnormal nerve sensations, a symptom called paresthesia. It can cause pinprick, burning, zinging, shooting, and tingling sensations, as well as itchiness.

Paresthesia is usually caused by damaged nerves (neuropathy). That used to perplex researchers because they didn't have evidence of nerve damage. However, that has changed.

Fibromyalgia Itch Research

Fibromyalgia studies have revealed small-fiber neuropathy (SFN), which is damage to specific parts of certain nerves. A 2019 analysis of existing research found 49% of people with fibromyalgia had SFN.

The itch sensations, much like fibromyalgia pain, appear to come from problems with signals sent between nerves. SFN symptoms that are common in fibromyalgia include:

  • Paresthesia
  • Allodynia

SFN is often diagnosed with a skin-punch biopsy. A doctor uses a circular scalpel to remove a small skin sample that is then examined under a microscope.

So your healthcare provider may be able to verify whether the condition is behind your itch.

ME/CFS Itch Research

Less research has been done on itchiness in ME/CFS.

  • A 2019 review of research found ME/CFS may also involve small-fiber neuropathy.
  • A 2014 study suggested a link between ME/CFS and immune-system inflammation, a known cause of neuropathy.

About 92% of people with small-fiber neuropathy have both neuropathic itch and pain. The neurons (brain cells) that sense itch are almost identical to those that detect pain.

What Can Help?

This isn't a "normal" itch. Scratching doesn't relieve it and, in some cases, could make it worse.

Things that may help include:

  • Capsaicin: A topical pain reliever that keeps your nerves from sending pain signals to the brain.
  • Ice: Numbs and relieves inflammation that compresses nerves.
  • Painkillers: Tylenol (acetaminophen) is likely the best over-the-counter pain reliever for itch.
  • Calming the nervous system: Certain supplements (theanine, rhodiola), Xyrem (sodium oxybate), Valium (diazepam), Xanax (alprazolam), acupuncture, yoga, and meditation may calm oversensitive nerves.

Other possible treatments being explored in early research include immunotherapy, treatments aimed at certain cells that fight infection, and a type of pain medication called a kappa-opioid agonist.

Summary

Research isn't conclusive, but evidence suggests the itch of fibromyalgia and ME/CFS comes from abnormal nervous and immune systems.

Small-fiber neuropathy and immune-related inflammation are under scrutiny.

Topical treatments and oral painkillers may help relieve neuropathic itch. Medications, supplements, and complementary/alternative treatments that calm the nervous system may also help.

A Word From Verywell

Remember, too, that there are plenty of other things that can make you itch as well.

Watch for links between your itch and food, skincare products, and other potential allergens. Also note that itching can be a side effect of opioid painkillers, such as Vicodin (hydrocodone-acetaminophen) and OxyContin (oxycodone).

No matter the suspected cause, let your healthcare provider know about your itch. They may be able to help you find successful treatments.

Chronic Fatigue Syndrome Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

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