Musculoskeletal Pain

The main symptom of the chronic pain condition called fibromyalgia is musculoskeletal pain. The pain related to fibromyalgia is not caused by an injury, but is thought to be neurological in origin. The pain itself is felt in muscles, tendons and connective tissues of the body, or the soft tissues.

Fibromyalgia patients often describe fibromyalgia pain as a consistent dull aching sensation, but the pain may be more mild or severe depending on the case. Other descriptions of the pain include “burning” or “shooting.” The musculoskeletal pain is usually widespread throughout the body as opposed to located in one limb or one side of the body, for instance. A person with fibromyalgia usually has pain in many different muscles.

Fibromyalgia may result in pain that seems to be arising from the joints. However, unlike the many different types of arthritis, the joints are not actually affected by fibromyalgia. Arthritis damages the joints and may cause deformity of joints, while people with fibromyalgia may feel pain and stiffness around their joints because of the muscles and tendons around the joints being affected, but the joints themselves are normal. X-rays and other types of medical imaging, such as MRI scans, show normal joint capsules without any degeneration in fibromyalgia patients.

In fibromyalgia patients, some parts of the body may feel more painful than others. These points are referred to as “tender points” and are commonly located on the lower back, the shoulders, the back of the head, the neck, the shins, the hips, the elbows, the knees and the chest. If these areas are pressed, they feel sore and painful.

In some fibromyalgia patients, the pain level remains roughly constant all day. In others, the symptoms may wax and wane depending on a variety of factors. Some fibromyalgia patients feel better during certain times of the day, usually in the middle of the day, with the pain worsening at night. Fibromyalgia patients may wake up feeling achy and stiff in the morning. Physical activity may worsen fibromyalgia pain in some cases. Some fibromyalgia patients report worsening pain when the weather is cold or humid. Stress and anxiety levels can also have an impact on fibromyalgia pain; the higher the levels of stress or anxiety, the worse the pain experienced by the fibromyalgia patient.

The cause of fibromyalgia is unknown, but researchers are beginning to understand the mechanism behind the pain related to fibromyalgia. It is most likely that fibromyalgia is caused by genetic factors that make a person more susceptible to developing the disease and environmental triggers, such as an infection or some kind of trauma.

The reason why musculoskeletal pain is present in fibromyalgia patients appears to be neurological. People naturally have slightly different thresholds that determine which sensations their brains interpret as painful. Some people have a higher or lower pain tolerance than others, meaning if two people experience the same potentially painful sensation, one person may consider it more painful than the other. This is due to a difference in how their brains process pain sensations. It is thought by pain researchers that fibromyalgia patients interpret pain signals differently than normal people because their pain threshold is lower than normal. Instead of tuning out the sensations that most people’s brains can easily ignore, they pick up these signals and interpret these sensations as real pain in their muscles, tendons and connective tissues.

It may be difficult for a person who does not have fibromyalgia to understand what it is like. People with fibromyalgia have brains that overreact to pain sensations, but this is not under conscious control. There is no way that fibromyalgia patients can tune out these pain signals, because they are physiologically sensitized to them. The pain that fibromyalgia patients feel is very real, and it has to do with levels of chemicals called neurotransmitters involved in the pain response and the interpretation of pain in the brain. Fibromyalgia patients may be told frequently that there is nothing wrong with them because fibromyalgia does not show up on any medical imaging studies or blood tests, but they are suffering from a real chronic musculoskeletal pain disease.


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