Muscle Spasms in Fibromyalgia and Chronic Fatigue Syndrome

Muscle spasms can be a source of considerable pain in many people with fibromyalgia and chronic fatigue syndrome. Muscles clench and just won't relax, sometimes in spite of multiple treatments. These conditions often show up alongside others, like irritable bowel and irritable bladder syndromes, that involve smooth muscle spasm.

Taut, hard, painful muscles can keep you awake and limit activity significantly. In addition to chronic spasms, you may also get random spasms occurring anywhere in the body, hitting out of the blue.

Treating Muscle Spasms

The most common treatment for muscle spasms is muscle relaxants such as Flexeril (cyclobenzaprine). Often, these medications are not a complete fix.

Some supplements are believed to help with muscle spasms, including:

• Magnesium
• Malic acid
• Calcium
• Zinc
• B vitamins
• Vitamin D

As is often the case with supplements, there is no solid evidence that they're effective. There's little to no research on how supplements affect fibromyalgia or chronic fatigue syndrome.

Some people get relief from therapies including:

• Acupuncture
• Cupping
• Massage, especially myofascial release
• Trigger point injections
• Physical therapy

At home, you can try:

• Massage devices
• Heat
• Ice
• Stretching, yoga, tai chi
• Topical muscle creams/patches

Many of these treatments can also have effects on other symptoms you may be experiencing.

What Causes Muscle Spasms?

Researchers haven't gotten to the root of these muscle spasms yet. But they are exploring several different possibilities.

Myofascial Trigger Points

Some studies show a link between muscle spasms and myofascial trigger points. Trigger points (TrPs) are small, ropy bands of muscle tissue that are in constant spasm but can get better or worse at times. They generally result from an injury that doesn't heal properly. Someone with chronic pain from multiple TrPs may have myofascial pain syndrome, a condition that's strongly linked to fibromyalgia. (But TrPs are different from the tender points used to diagnose fibromyalgia.)

An important characteristic of TrPs is that they can cause referred pain. In other words, they cause pain away from where they are, so an active trigger point in your neck may cause what feels like sinus pain around your eyes. So when a healthcare provider looks at where it hurts, there's nothing wrong.

In one study, researchers were able to recreate the seemingly random pain of fibromyalgia by manipulating TrPs. That suggests that at least some of fibromyalgia pain may be caused by TrPs. The good news there is that TrPs can be treated.

Nervous System Dysfunction

Another possible cause of muscle spasms is a problem in the nervous system. Nerves could send signals improperly, causing twitches or spasms.

Muscle Cell Energy Deficits

While research is lacking in this area, we do know that it takes more energy for a muscle to relax than to contract. In fact, it takes twice as much. Here's how it works:

• When a muscle contracts, small pouches in the cells release calcium.
• For the muscle to relax, the cell needs to pump the calcium back into the pouch.
• When energy is low, the cell can't perform that job and the muscle stays contracted.

Given the energy deficits of fibromyalgia and chronic fatigue syndrome, perhaps there is a connection.

Mitochondrial Dysfunction

Researchers are looking at how our cells and the mitochondria within them function, exploring the theory that illnesses, including fibromyalgia and chronic fatigue sydrome, involve mitochondrial dysfunction.

According to some research, supplements that can increase cellular energy and mitochondrial function include:

• B-12
• Magnesium
• Carnitine
• CoQ10
• D-ribose
• NADH
• Creatine

Magnesium and B-12 are also listed as helping with muscle spasms.

A Word From Verywell

While you may not be able to eliminate muscle spasms, you have a lot of treatment and management options that may help you feel and function better. As always, talk to your healthcare provider, experiment with a variety of safe treatments, and keep doing what works.