The 7 Types of Fibromyalgia Pain

Fibromyalgia is a chronic condition that causes pain in the muscles, skin, and joints. Fibromyalgia syndrome (FMS) has been a recognized illness for more than 30 years. Still, many people with this condition have been told their symptoms are only in their heads.

That's because attacks can come and go, and the pain can move around the body. There is also no specific test to confirm fibromyalgia. Since pain differs from person to person, it can be difficult for doctors to diagnose FMS.

This review will help you learn more about your FMS pain and ways to ease it. Or it can help you better understand what people with fibromyalgia experience and how to help and support them.

Woman experiencing neck pain

George Rudy / iStock

Symptoms

About 2% of US adults have fibromyalgia.The disease itself isn't deadly, but it is 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.

Researchers say this is because it's hard to live with pain. FMS patients tend to be exhausted and have emotional and mental health issues. Many people also don't understand their condition. Doctors don't know what causes fibromyalgia, and there's no cure.

Other symptoms common among people with FMS include:

  • Sleep difficulties
  • Exhaustion
  • Depression
  • Anxiety
  • Brain fog
  • Memory issues
  • Concentration problems
  • Headaches
  • Tingling or numbness in hands and feet
  • Pain in the face or jaw
  • Abdominal pain
  • Bloating
  • Constipation

By far, though, the most common symptom is throbbing pain. Researchers have linked seven distinct types of pain to FMS. How many of these a person has and the severity varies widely.

Hyperalgesia

Hyperalgesia is the medical term for the increased sense of pain you feel due to fibromyalgia. Scientists don't fully understand this condition. 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

If you feel like you always have the flu or "hurt all over," you're not alone. Widespread muscle pain is a hallmark of fibromyalgia. 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, many doctors also prescribe physical therapy and massage to help ease the pain. Any movement can be difficult when you're in pain, but doctors recommend 30 minutes a day of light exercise.

Exercises like yoga, walking, or swimming help you 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.

Some FMS treatments are antidepressants. These drugs can make you clench or grind your teeth when you sleep. This worsens TMJ pain and can damage your teeth.

Your dentist might suggest wearing a mouth guard. 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

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 odd 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.

Headaches

FMS can cause headaches. A study in the Journal of Headache Pain found that over one-third of people with tension headaches and nearly a quarter of people with migraines also have 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.

Central Sensitization

Researchers believe anxiety and poor sleep are behind fibromyalgia headaches. Stress and poor sleep are known to contribute to the heightened perception of pain people with FMS have.

Abdominal and Pelvic Pain

Nearly half 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.

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. Researchers in Taiwan found that people with fibromyalgia are about one and a half times more likely to have acid reflux.

Besides abdominal pain, women with fibromyalgia may have pelvic pain due to bladder pain. This can cause an increased urge to pee or frequent peeing.

Fibromyalgia Doctor Discussion Guide

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

Doctor Discussion Guide Woman

Summary

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 prevent pain.

It's hard to live with fibromyalgia, especially since painful attacks can be unpredictable. Finding the right set of treatments takes time and experimentation. With dedication and practice, many do find relief.

Frequently Asked Questions

  • Can periods make fibromyalgia worse?

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

  • Can you die from fibromyalgia?

    No, fibromyalgia is not 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.

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21 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. Centers for Disease Control and Prevention. Fibromyalgia. Last reviewed January 6, 2020.

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

  3. Cleveland Clinic. Fibromyalgia; symptoms, causes, treatment. Last reviewed November 1, 2020.

  4. 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

  5. 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

  6. Food and Drug Administration. Living with fibromyalgia, drugs approved to manage pain. Published January 31, 2014.

  7. da Silva L, Kazyiama HH, de Siqueira JTT, Teixeira MJ, de Siqueira S. High prevalence of orofacial complaints in patients with fibromyalgia: a case–control study. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2012;114(5):e29-e34. doi:10.1016/j.oooo.2012.04.001

  8. 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

  9. Cleveland Clinic. Should you use a dental mouthguard for your jaw pain? Published April 29, 2021

  10. 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

  11. 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

  12. 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

  13. 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

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

  15. 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

  16. 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

  17. 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

  18. 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

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

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

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