The 8 Types of Fibromyalgia Pain

Fibromyalgia is a chronic condition that causes pain in the muscles, skin, and joints. There are eight main types of fibromyalgia pain, and it's very likely you'll experience several of them if you have this condition.

Types of fibromyalgia pain include:

  • Hyperalgesia
  • Widespread muscle pain and fatigue
  • Temporomandibular joint pain (TMJ)
  • Allodynia
  • Neuropathic pain
  • Headaches
  • Digestive pain
  • Pelvic pain

This article will describe the eight types of pain in fibromyalgia (also called fibromyalgia syndrome, or FMS) and how they can be treated.

Shot of a young woman experiencing neck pain while using a laptop on the sofa at home - stock photo

Moyo Studio / Getty Images


Hyperalgesia is the medical term for the increased sense of pain you feel due to fibromyalgia. Scientists don't fully understand this condition but they believe the brains of people with fibromyalgia are more sensitive to pain signals.

In a study published in Clinical Neurophysiology, researchers inserted needles attached to monitors into the upper arm muscles of 21 women with fibromyalgia.They recorded the electrical activity when they pressed down on the women's muscles with different amounts of force. Then they compared the results to 21 healthy women and 25 women with chronic fatigue syndrome, which causes extreme tiredness.

The researchers reported that the tissues surrounding the muscles in women with fibromyalgia overreacted to the lightest touch. Muscle activity was the same in all three groups. The researchers believe that the nervous systems of the women with FMS were sending signals that caused the tissues to remain on high alert.

Widespread Muscle Pain

Widespread muscle pain is a hallmark of fibromyalgia. It can make you feel like you have the flu or "hurt all over." Many people with fibromyalgia also tend to have:

  • Low back pain, which may spread into the buttocks and legs
  • Pain and tightness in the neck that moves across the back of the shoulders
  • Pain between the shoulder blades
  • Pain in the breastbone and rib cage that feels like a heart attack

The Food and Drug Administration has approved three drugs to help relieve fibromyalgia pain. They include two antidepressants, Cymbalta (duloxetine) and Savella (milnacipran), and the anti-seizure drug Lyrica (pregabalin).

In addition to medication, physical therapy and massage may help to help ease the pain. Any movement can be difficult when you're in pain, but doctors also recommend 30 minutes a day of light exercise.

Exercises like yoga, walking, or swimming help loosen your muscles and joints and maintain your flexibility. One study found that exercising in a pool with warm water for just two weeks decreased pain by 15% in women with fibromyalgia.

TMJ Pain

One of the most common joint problems in people with FMS is pain in the temporomandibular joint (TMJ). This connects your jaw to your skull on either side of your face. TMJ pain is often described as a dull, persistent ache that affects the ear, temple, eyes, lower jaw, or neck. Dentists usually diagnose TMJ.

Your dentist might suggest wearing a mouth guard to wear while you sleep to keep you from grinding your teeth. You can buy "boil and bite" ones in pharmacies and sporting goods stores. Dentists can make custom-fit ones, but they cost more.

For TMJ pain, try taking anti-inflammatory drugs such as Aleve (naproxen) or Advil (ibuprofen). If your pain persists, ask about a muscle relaxant or an FDA-approved FMS pain drug.


Allodynia is a kind of skin pain where even the lightest touch can hurt. Mild clothing pressure from a waistband or bra strap can feel painful. Researchers believe central sensitization causes allodynia. This means the brain, nerves, and spinal cord overreact to sensations.

Specialized nerves called nociceptors sense information through the skin about things like temperature. They cause you to react immediately. That's why you jerk your hand away when you touch something hot.

When these nerves become overly sensitized, your body interprets sensations as pain. Many people with FMS describe allodynia as their skin constantly feeling like it's badly sunburned. The prescription drug Lyrica (pregabalin) can help treat allodynia.

Neuropathic Pain

Neuropathic pain causes feelings of crawling, tingling, burning, itching, or numbness in the arms and legs. In severe cases, these sensations can be painful. Still, patients have typical reflexes and strength.

Prescription fibromyalgia treatments can help ease neuropathic pain. Some people with FMS find that over-the-counter capsaicin cream can help numb the pain. This is a painkiller made from peppers. Skin rubs with lidocaine, like Ben Gay, can also be helpful.

Two review studies suggest taking vitamin B1, B6, and B12 supplements might help ease neuropathic pain. However, the studies didn't look specifically at neuropathic pain caused by fibromyalgia. Dosages also varied widely in the studies.


Both tension headaches and migraines are very common in people with fibromyalgia

Tension headaches cause a dull, tightening pressure sensation all around the head. While uncomfortable and nagging, they are not disabling. Migraines are more painful. They often occur on one side of the head and may be associated with light and sound sensitivity.

A 2018 study in the Journal of Headache and Pain concluded that migraine headaches are more severe and intense in people with fibromyalgia than in those without the condition.

Migraines can be treated with prescription medications, such as triptans, non-steroidal anti-inflammatory drugs (NSAIDs), and neuromodulation devices. Avoiding common triggers of migraines (such as certain foods or flashing lights) can help prevent the onset of a migraine.

Digestive Pain

It's estimated that up to 70% of people with fibromyalgia are also diagnosed with irritable bowel syndrome (IBS). This is a digestive disorder that causes cramping, belly pain, constipation, diarrhea, and nausea.

IBS can be difficult to treat, but lifestyle strategies and an array of medications are often effective.

Acid reflux is another digestive disorder common among people with fibromyalgia. This occurs when stomach acid flows back up the tube connecting your stomach and mouth.

Gastroesophageal reflux disease (GERD) is a chronic form of acid reflux that is also more common in people with fibromyalgia.Researchers in Taiwan found that people with fibromyalgia are about one and a half times more likely to have acid reflux.

GERD and acid reflux is typically treated with over-the-counter antacids, prescription medications, and lifestyle measures, including dietary changes.

Fibromyalgia Doctor Discussion Guide

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

Doctor Discussion Guide Woman

Pelvic Pain

Besides abdominal pain, women with fibromyalgia may experience pelvic pain, including bladder pain. This can cause an increased urge to urinate and/or frequent urination.

Women with endometriosis, a painful condition in which endometrial tissue grows outside of the uterus, are also 6% more like to have fibromyalgia than women without it, according to a 2019 study.

Treatments for endometriosis include hormonal therapies, complementary therapies, lifestyle measures, and, in some cases, surgical procedures including hysterectomy.

The Impact of Fibromyalgia Pain

About 2% of US adults have fibromyalgia, according to the Centers for Disease Control and Prevention.

Living with the pain involved in fibromyalgia can be stressful. FMS patients are often exhausted and may have emotional and mental health issues. Adding to this is the fact that fibromyalgia is a misunderstood condition (and often dismissed), and currently, there is no cure.

FMS is also associated with an increased risk of suicide. Studies show between 27% and 58% of people with fibromyalgia report having feelings of hopelessness, depression, and thoughts of suicide.

If you or someone you know are having suicidal thoughts, dial 988 to contact the 988 Suicide & Crisis Lifeline and connect with a trained counselor. For more mental health resources, see our National Helpline Database.


Fibromyalgia is a chronic illness that causes pain in the body's muscles, skin, and joints. Researchers believe that the nervous systems of people with fibromyalgia are overly sensitive to pain.

The FDA has approved three medications to treat fibromyalgia pain. Exercise helps patients loosen their muscles and joints and maintain flexibility. Other lifestyle choices such as reducing stress and getting enough sleep can also help FMS patients manage pain.

It can be hard to live with fibromyalgia, especially since painful attacks can be unpredictable. Finding the right treatments may take time and experimentation. With dedication, many people with FMS do find relief.

20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Sluka KA, Clauw DJ. Neurobiology of fibromyalgia and chronic widespread painNeuroscience. 2016;338:114-129. doi:10.1016/j.neuroscience.2016.06.006

  2. Centers for Disease Control and Prevention. Fibromyalgia.

  3. Klaver-Krol EG, Hermens HJ, Vermeulen RC, et al. Chronic fatigue syndrome: Abnormally fast muscle fiber conduction in the membranes of motor units at low static force load. Clin Neurophysiol. 2021;132(4):967-974. doi:10.1016/j.clinph.2020.11.043

  4. Food and Drug Administration. Living with fibromyalgia, drugs approved to manage pain.

  5. Sahbaz T, Karacay BC.

    Investigation of temporomandibular disorders in patients with fibromyalgia syndrome: A case-control study. Journal of Stomatology, Oral and Maxillofacial Surgery,

    Volume 124, Issue 1, Supplement, 2023. doi:10.1016/j.jormas.2022.09.017

  6. Gui MS, Pimentel MJ, Rizzatti-Barbosa CM. Temporomandibular disorders in fibromyalgia syndrome: a short-communication. Rev Bras Reumatol. 2015;55(2):189-194. doi:10.1016/j.rbre.2014.07.004

  7. Sumpton JE, Moulin DE. Handbook of Clinical Neurology, Elsevier, Volume 119,

    2014, Pages 513-527. doi:10.1016/B978-0-7020-4086-3.00033-3

  8. Viana F. Nociceptors: thermal allodynia and thermal pain. Handb Clin Neurol. 2018;156:103-119. doi:10.1016/B978-0-444-63912-7.00006-0

  9. Verma V, Singh N, Singh Jaggi A. Pregabalin in neuropathic pain: evidences and possible mechanisms. Curr Neuropharmacol. 2014;12(1):44-56. doi:10.2174/1570159X1201140117162802

  10. Häuser W, Fitzcharles M (2018) Facts and myths pertaining to fibromyalgiaDialogues in Clinical Neuroscience, 20:1, 53-62, doi:10.31887/DCNS.2018.20.1/whauser

  11. Cavalli E, Mammana S, Nicoletti F, Bramanti P, Mazzon E. The neuropathic pain: An overview of the current treatment and future therapeutic approaches. Int J Immunopathol Pharmacol. 2019;33:2058738419838383. doi: 10.1177/2058738419838383

  12. Geller M, Oliveira L, Nigri R, et al. B vitamins for neuropathy and neuropathic pain. Vitamins and Minerals 2017;6:161.

  13. Whealy M, Nanda S, Vincent A, Mandrekar J, Cutrer FM. Fibromyalgia in migraine: a retrospective cohort study. J Headache Pain. 2018 Jul 31;19(1):61. doi:10.1186/s10194-018-0892-9

  14. Whealy M, Nanda S, Vincent A, Mandrekar J, Cutrer FM. Fibromyalgia in migraine: a retrospective cohort studyJ Headache Pain. 2018;19(1):61. doi:10.1186/s10194-018-0892-9

  15. Chang, L. University of North Carolina for Functional and GI Motility Disorders. The association of irritable bowel syndrome and fibromyalgia.

  16. Wang J-C, Sung F-C, Men M, Wang KA, Lin C-L, Kao C-H. Bidirectional association between fibromyalgia and gastroesophageal reflux disease: two population-based retrospective cohort analysis. 2017;158(10):1971-1978. doi:10.1097/j.pain.0000000000000994

  17. Jones KD, Maxwell C, Mist SD, King V, Denman MA, Gregory WT. Pelvic floor and urinary distress in women with fibromyalgia. Pain Manag Nurs. 2015;16(6):834-840. doi:10.1016/j.pmn.2015.06.001

  18. Greenbaum H, Weil C, Chodick G, Shalev V, Eisenberg VH. Evidence for an association between endometriosis, fibromyalgia, and autoimmune diseases. Am J Reprod Immunol. 2019 Apr;81(4):e13095. doi: 10.1111/aji.13095

  19. Levine D, Horesh D. Suicidality in fibromyalgia: a systematic review of the literature. Front Psychiatry. 2020;11:535368. doi:10.3389/fpsyt.2020.535368

Additional Reading

By Adrienne Dellwo
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.