Extreme Itch in Fibromyalgia and Chronic Fatigue Syndrome

A result of nerve damage?

That constant itch may be part of your fibromyalgia or myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). These conditions involve the central nervous system. So strange nerve problems can crop up. 

An itch that comes from the nerves and brain is called a neuropathic itch. It can be severe and hard to stop.

A fibromyalgia pain type called allodynia can be triggered by touch or rubbing the skin. That means 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

Pain and Itch: The Connection

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.

Why Do You Itch?

One fibromyalgia survey found itchiness without a known cause in about 2% of people with the condition. However, they only looked at symptoms that participants reported.

Many people don't know their itch is a fibromyalgia symptom. So 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 nerves—and entire nervous systems—that aren't normal. The immune system may also play a role.

Many people with these conditions have a symptom called paresthesia. That's abnormal nerve sensations. It can cause pinpricks, burning, tingling, and itchiness.

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

Fibromyalgia Itch Research

Fibromyalgia studies have revealed small-fiber neuropathy (SFN). SFN is damage to specific parts of certain nerves. A 2019 meta-analysis of 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
  • Burning sensations
  • Allodynia

SFN is often diagnosed with a skin-punch biopsy. So your doctor may be able to verify whether it's behind your itch.

An Opioid Side Effect?

If you take opioid painkillers—such as Vicodin (hydrocodone-acetaminophen) and OxyContin (oxycodone)—your itch could be a side effect.

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. That's a known cause of neuropathy.

What Can Help?

This isn't a "normal" itch. Scratching doesn't relieve it. Things that may help include:

  1. Capsaicin: A topical pain reliever that keeps your nerves from sending signals.
  2. Ice: Deadens feeling and relieves inflammation that compresses nerves.
  3. Painkillers: Acetaminophen, the drug in Tylenol, is likely the best over-the-counter pain reliever for itch.
  4. Calming the nervous system: Certain supplements (theanine, rhodiola), medications (Xyrem, Valium, Xanax), acupuncture, yoga, and meditation may calm over-sensitive nerves.

Other possible treatments being explored in early research include immunotherapy, treatments aimed at certain antibodies (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 systems 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, or complementary/alternative treatments that calm the nervous system may also help.

A Word From Verywell

Lots of things other than nerve dysfunction can make you itch. Watch for links between your itch and food, skin-care products, and other potential allergens.

No matter the suspected cause, you should 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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