Muscle Spasms in Fibromyalgia and Chronic Fatigue Syndrome

These spasms can be a very painful symptom

A woman rubs her aching shoulder
Jose Luis Pelaez Inc / Getty Images

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:

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:

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 doctor 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 doctor, experiment with a variety of safe treatments, and keep doing what works.

Was this page helpful?

Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Liu Y, Qian C, Yang M. Treatment patterns associated with ACR-recommended medications in the management of fibromyalgia in the United States. J Manag Care Spec Pharm. 2016;22(3):263-71. doi:10.18553/jmcp.2016.22.3.263

  2. Gröber U, Schmidt J, Kisters K. Magnesium in prevention and therapy. Nutrients. 2015;7(9):8199-226. doi:10.3390/nu7095388

  3. Qiang F. Effect of malate-oligosaccharide solution on antioxidant capacity of endurance athletes. Open Biomed Eng J. 2015;9:326-9. doi:10.2174/1874120701509010326

  4. American Academy of Orthopaedic Surgeons. Muscle cramps. Updated June 2017.

  5. Barros-Neto JA, Souza-Machado A, Kraychete DC, et al. Selenium and zinc status in chronic myofascial pain: Serum and erythrocyte concentrations and food intake. PLoS ONE. 2016;11(10):e0164302. doi:10.1371/journal.pone.0164302

  6. Huang ZF, Lin BQ, Torsha TT, Dilshad S, Yang DS, Xiao J. Effect of mannitol plus vitamins B in the management of patients with piriformis syndrome. J Back Musculoskelet Rehabil. 2019;32(2):329-337. doi:10.3233/BMR-170983

  7. Ibáñez-Vera AJ, Alvero-Cruz JR, Garcia-Romero JC. Therapeutic physical exercise and supplements to treat fibromyalgia. Apunts Medicina de l'Esport. 2018;53(197):33-41. doi:10.1016/j.apunts.2017.07.001

  8. Arranz LI, Canela MÁ, Rafecas M. Dietary aspects in fibromyalgia patients: results of a survey on food awareness, allergies, and nutritional supplementation. Rheumatol Int. 2012;32(9):2615-21. doi:10.1007/s00296-011-2010-z

  9. Skaer TL. Current issues regarding the care of the fibromyalgia patientFibrom Open Access. 2017;2(1):1000120.

  10. Ge HY, Wang Y, Fernández-de-las-Peñas C, Graven-Nielsen T, Danneskiold-Samsøe B, Arendt-Nielsen L. Reproduction of overall spontaneous pain pattern by manual stimulation of active myofascial trigger points in fibromyalgia patients. Arthritis Res Ther. 2011;13(2):R48. doi:10.1186/ar3289

  11. Cohen H. Controversies and challenges in fibromyalgia: a review and a proposal. Ther Adv Musculoskelet Dis. 2017;9(5):115-127. doi:10.1177/1759720X17699199

  12. Cordero MD, Alcocer-Gómez E, de Miguel M, et al. Can coenzyme q10 improve clinical and molecular parameters in fibromyalgia?. Antioxid Redox Signal. 2013;19(12):1356-61. doi:10.1089/ars.2013.5260

  13. Nicolson GL. Mitochondrial dysfunction and chronic disease: Treatment with natural supplements. Integr Med (Encinitas). 2014;13(4):35-43.