The 7 Types of Fibromyalgia Pain

Those with fibromyalgia (FMS) have a shared experience of living with pain. But what that feels like can be quite different from person to person due to the fact that there are so many different types of fibromyalgia pain.

Woman experiencing neck pain
GeorgeRudy / iStockphoto

Some break it down into seven varieties: hyperalgesia, allodynia, paresthesia, muscle pain, joint pain, headaches, and abdominal pain. How many of these one has, and to what extent, varies widely—and this can change over time.

By reviewing the ways fibromyalgia pain can manifest, at the very least, you can feel more at ease knowing that you are not alone in your experience. If your loved one has fibromyalgia, understanding how complex and multi-faceted fibromyalgia pain is can help you better understand what he or she is going through.


"Hyper" means excess and "algesia" means pain. Hyperalgesia is the medical term for pain amplification in FMS. Our brains appear to take normal pain signals and "turn up the volume," making them more severe than they would normally be. And when your brain says pain is severe, it actually becomes severe.

Most of the drugs used for managing FMS pain are aimed, at least in part, at reducing hyperalgesia.

Widespread Muscle Pain

You are not alone if you feel like you always have the flu, or if you "hurt all over."

Diffuse and persistent muscle and soft tissue pain (sometimes referred to as myofascial pain) is commonly described as a deep and gnawing soreness, stiffness, aching, or throbbing all over the body, including the arms, legs, neck, and shoulders—is a hallmark feature of fibromyalgia.

Many are most often bothered by:

  • Low back pain, which may radiate into the buttocks and legs
  • Pain and tightness in the neck that moves across the back of the shoulders
  • Chest wall pain, suggestive of symptoms of costochondritis

Keep in mind that early on in the disease, a person may note pain confined to one specific area, like the neck and shoulders. As part of the diagnosis of fibromyalgia, a doctor may identify areas of the body called "tender points" that hurt when pressed on with only mild to moderate pressure.

Joint Pain

Joint aching and a sensation of swelling are common in people with fibromyalgia. More specifically, pain located at the temporomandibular joint (TMJ), which connects your jaw to your skull on either side of your face, is common.

TMJ pain is often described as a dull, persistent ache that can move to the ear, temple, around the eyes, the lower jaw, or back of the neck.


Is your skin painful to the touch? Allodynia, when mild pressure from clothing or gentle massage causes pain, is a symptom that perplexes many. It is believed to be a hypersensitive reaction that may result from the central sensitization associated with FMS.

The pain signals originate with specialized nerves, called nociceptors, that sense information about things like temperature and painful stimuli right from the skin. A lot of people describe allodynia as skin sensitivity that is similar to a bad sunburn.

Allodynia is a fairly rare type of pain—other than FMS, it's only associated with a handful of conditions, including neuropathy, postherpetic neuralgia (shingles), and migraine.

Neuropathic Pain

Many people with fibromyalgia describe neuropathic pain, which causes odd nerve sensations that feel like crawling, tingling, burning, itching, or numbness in the arms and legs. Sometimes, these sensations can be painful. Strength, reflexes, and sensations are all normal, despite this neuropathic pain.

Many common fibromyalgia treatments can help alleviate neuropathic pain in fibromyalgia, including selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). Some people also find vitamin B12, capsaicin cream, massage, and acupuncture helpful.


Headaches, though common in general, can also be a result of or associated with fibromyalgia. Tension headaches are the most common type experienced by those with FMS.

According to a study in the Journal of Headache Pain, of those with tension headaches, nearly 35% also have fibromyalgia. Migraine headaches follow, with approximately 24% of migraineurs also having a diagnosis of fibromyalgia.

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

Some people with migraines also experience a migraine aura, a neurological disturbance that typically involves vision changes, like seeing flashing or shimmering lights, kaleidoscopic shapes, or zigzag lines.

Central Sensitization

Anxiety and poor sleep are two factors that link headache disorder to fibromyalgia. Both anxiety and poor sleep are known to contribute to central sensitization—the heightened perception of pain. This is the foundation upon which fibromyalgia and chronic headache disorders are believed to develop.

Abdominal and Pelvic Pain

The prevalence of irritable bowel syndrome (IBS), a digestive disorder characterized by cramping abdominal pain and bloating, is nearly 50% in people with fibromyalgia. Other symptoms of IBS include constipation, diarrhea, nausea, a feeling of incomplete evacuation, and mucus in the stools.

Acid reflux, too, is commonly seen in people with fibromyalgia and causes heartburn, and sometimes regurgitation, among other symptoms.

Besides abdominal pain, people with fibromyalgia may experience pelvic pain, especially discomfort that comes from the bladder. Pelvic pain in fibromyalgia may be associated with symptoms of interstitial cystitis, such as an increased urge to urinate and increased urinary frequency.

Fibromyalgia Doctor Discussion Guide

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

Doctor Discussion Guide Woman

A Word From Verywell

It's difficult to live with fibromyalgia pain, especially when it's unpredictable. The more you learn about your pain and its triggers, the better you may be able to manage it.

For instance, we know that moderate exercise and adequate sleep can improve symptoms and that physical or mental stress, cold and damp weather, and poor sleep can worsen them. Finding the right set of treatments takes time and experimentation, but many do find significant relief with dedication and patience.

Frequently Asked Questions

  • Can periods make fibromyalgia worse?

    Yes. Just before you get your period, when hormone levels go down, you may experience more severe symptoms including body pain and headaches. Fatigue and insomnia may also be worse just before your monthly menstruation.

  • Can you die from fibromyalgia?

    No. Fibromyalgia doesn’t seem to be fatal. The mortality rate is about the same for those with and without fibromyalgia. However, there does seem to be a greater risk for suicide and accidents for those suffering from fibromyalgia.

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 process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Wong F, Rodrigues A, Schmidt S, Vierck CJ, Mauderli AP. Extreme thermal sensitivity and pain-induced sensitization in a fibromyalgia patient. Pain Res Treat. 2010;2010:912513. doi:10.1155/2010/912513

  2. American College of Rheumatology. How is fibromyalgia diagnosed? Updated March 2019

  3. 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

  4. Koroschetz J, Rehm SE, Gockel U, et al. Fibromyalgia and neuropathic pain--differences and similarities. A comparison of 3057 patients with diabetic painful neuropathy and fibromyalgia. BMC Neurol. 2011;11:55. doi:10.1186/1471-2377-11-55

  5. de Tommaso M, Federici A, Serpino C, et al. Clinical features of headache patients with fibromyalgia comorbidityJ Headache Pain. 2011;12:629-638. doi:10.1007/s10194-011-0377-6

  6. Kim YS. Why should gastroenterologists know about fibromyalgia? Common pathogenesis and clinical implications. J Neurogastroenterol Motil. 2011;17(1):1-3. doi:+10.5056/jnm.2011.17.1.1

  7. U.S. Department of Health and Human Services. Office on Women’s Health. Fibromyalgia. Updated April 1, 2019.

  8. Wolfe F, Hassett AL, Walitt B, Michaud K. Mortality in fibromyalgia: A study of 8,186 patients over thirty-five years: Mortality in Fibromyalgia. Arthritis Care Res. 2011;63(1):94-101. doi:10.1002/acr.20301

Additional Reading