As anyone with fibromyalgia knows, there are times when symptoms are more acute and intense than normal. These times are commonly known as fibromyalgia flares (or flare-ups).
Fibromyalgia flares can last anywhere from one day to several weeks at a time and often have a trigger associated with them. Understanding the common triggers of fibromyalgia flares can help sufferers develop a strategy to lessen the number of occurrences in the future.
Reducing stress from one’s life is not an easy task but doing so is likely to result in fewer flare-ups over time. Making lifestyle changes such as taking time to relax, starting yoga classes, and making your health a priority is among the suggestions that we often hear.
On bad days, it can be hard to just get out of bed. On good days, fibromyalgia sufferers often push themselves to catch up on tasks and responsibilities that they have been unable to tackle.
But this can result in physical over-exertion that will trigger a fibromyalgia flare. For this reason, we recommend pacing of physical activities even on good days.
Sleeping problems are very common among those with fibromyalgia. Many reports waking up every day feeling exhausted as if they hadn’t slept at all.
Lack of sleep or changes to normal sleep patterns can definitely trigger a flare. Finding ways to ensure that you get truly restful and restorative sleep can be an important step to reducing the number of flares over time.
Fibromyalgia sufferers often change medications over time in their quest to find relief from their fibromyalgia symptoms. Changes caused by new medications can sometimes trigger a flare.
Ideally, you have a supportive doctor who can recommend alternative medications when necessary and also mitigate any unfavorable effects of making changes to your treatment protocol. If you don’t, it might be time to find a new doctor.
Fibromyalgia has long baffled both medical professionals and sufferers. Branded as a neurological syndrome characterized by chronic pain, fatigue, and cognitive dysfunction, fibromyalgia has defied precise categorization and treatment. However, emerging evidence introduces a compelling and often-overlooked player in this painful puzzle: fascia, the connective tissue that blankets every inch of our internal architecture.
Could it be that the discomfort fibromyalgia patients endure—those deep, radiating aches and that crawling, prickling sensation beneath the skin known as formication—isn’t just rooted in the brain, but in this intricate web of tissue just beneath the surface?
Let’s peel back the layers—literally and figuratively—of the human body to expose how fascial dysfunction might underpin fibromyalgia, and what that revelation means for the future of symptom management and healing.
What Is Fascia? The Underappreciated Matrix of the Body
Fascia is a thin, fibrous, and remarkably dynamic connective tissue that envelops every muscle, bone, nerve fiber, and internal organ. This fibrous matrix performs far more than structural duties; it is rich in sensory nerve endings and plays a critical role in proprioception, pain signaling, and internal communication.
Far from being inert packing material, fascia is alive with cellular activity and fluid dynamics. It:
Supports and stabilizes musculature and joints
Separates and connects anatomical structures simultaneously
Conducts mechanical signals, such as pressure and vibration
Interacts intimately with the central nervous system via embedded receptors
In essence, fascia is the body’s broadband network—and when that network becomes gnarled, compressed, or dehydrated, the resulting dysfunction can cascade throughout the system.
Fibromyalgia has traditionally been attributed to central sensitization—a condition in which the brain and spinal cord amplify pain signals. While this remains a crucial piece of the puzzle, it does not fully explain why the pain begins in specific areas, or why it’s often symmetrical, migratory, and resistant to common painkillers.
When this tissue becomes stiff, bound, or inflamed, it exerts abnormal pressure on nerves, impairs blood flow, and generates localized inflammation—all of which can mimic and potentially cause the widespread discomfort seen in fibromyalgia.
Formication is a tactile hallucination—a feeling that something is crawling on or under the skin. It often coexists with fibromyalgia and is profoundly distressing. While frequently linked to neuropathy or drug withdrawal, many fibro patients experience it without external triggers, suggesting a deeper somatic origin.
So how could fascia be responsible for this bizarre, bug-like sensation?
Entrapped Nerves: Fascial adhesions can compress sensory nerves, causing misfires that the brain interprets as crawling or tingling.
Abnormal Tension: Chronic fascial tightness distorts mechanoreceptor input, leading to bizarre tactile sensations.
Inflammatory Signaling: Fascia, rich in immune activity, may spark cytokine activity that sensitizes nerve endings.
Disrupted Fluid Flow: Impaired lymphatic and interstitial fluid movement due to fascial rigidity may alter skin sensation.
Together, these factors provide a plausible basis for formication as a peripheral-origin hallucination, originating in fascia and misinterpreted by the brain.
Recent studies show that fascia has a higher density of nociceptors (pain receptors) than muscle tissue. This suggests that pain attributed to “muscle soreness” may in fact originate in the fascia.
Imaging Insights
Ultrasound and MRI technologies have demonstrated that fibromyalgia patients often have thicker, less elastic fascia, especially in the trapezius, lumbar region, and lower extremities.
Cellular Inflammation
Biopsies and lab studies suggest that inflammatory markers in fascial tissues are elevated in fibro patients—supporting the theory of an immune-mediated fascial syndrome.
Feedback Loops Between Fascia and the Central Nervous System
Fascia doesn’t operate in isolation. It is intimately tied to the nervous system through:
Proprioceptors (sensors for movement and tension)
Baroreceptors (sensors for pressure)
Chemoreceptors (sensors for chemical signals like inflammation)
A stiffened or inflamed fascial environment sends constant “danger” signals to the brain, keeping the nervous system in a perpetual state of alert. This feeds into central sensitization, reinforcing both pain perception and emotional distress—a loop that’s tough to break without addressing the tissue dysfunction.
Many fibromyalgia patients have undergone a carousel of medications—from antidepressants to anticonvulsants to opioids—without sustainable relief. Addressing the mechanical and physiological health of fascia offers a promising avenue.
Integrative Care Model
An ideal fibromyalgia treatment plan might include:
There’s growing recognition that the nervous system does not operate in a vacuum. It is embedded within the fascia, nourished by its fluids, and influenced by its tension. When fascia falters, nerves suffer—and the body broadcasts its distress through pain, fatigue, cognitive fog, and bizarre sensations like formication.
By embracing fascia as a living, reactive, and treatable structure, we open new doors for people with fibromyalgia—doors that may lead to recovery, restoration, and resilience.
Remember:
Formication and fibromyalgia share common neural roots—an interwoven story of sensory misfiring. Though unwelcome and at times terrifying, this symptom responds to a multi-pronged plan grounded in nerve modulation, holistic care, medical oversight, and patient resilience. By embracing a broad, informed approach, individuals suffering from formication can reclaim comfort, control, and, above all, hope.
More Detail about Formication and Fibromyalgia: When It Feels Like Bugs Crawl Beneath Your Skin
Fibromyalgia is a multifaceted disorder. Beyond chronic musculoskeletal pain and profound fatigue, sufferers often report a constellation of distressing sensory symptoms. Among them, formication—the eerie sensation of insects crawling on or under the skin—emerges as one of the most unnerving. Its existence in fibromyalgia raises questions about the nature of the disease: Why would a person feel tiny creatures writhing beneath the surface? Why is it so common among fibromyalgia patients? And how can one manage or treat such a disturbing sensation?
Formication (pronounced for-MIH-kay-shun) is the clinical term for the illusion or hallucination of insects crawling on or under the skin. Derived from the Latin formica (“ant”), it classifies as a tactile hallucination—a sensory misperception where the skin feels touch, pressure, or movement that has no external source.
Psychosomatic or Neurological?
Although formication frequently appears in psychiatric conditions and stimulant drug use, such as chronic methamphetamine abuse, it is not solely a mental health phenomenon. The culprit is a misfiring nervous system—sensory signals being generated without any actual stimulus. The brain interprets these signals as crawling sensations, triggering a powerful, visceral reaction, even though no real bugs are present.
Why It’s So Distressing
Psychological torment: The sensation can feel all too real—driving sufferers to itch, scratch, or pick compulsively.
Docked sleep: The relentless crawling feeling can interrupt rest, triggering further physical and emotional exhaustion.
Risk of self-inflicted harm: Constant scratching may lead to open sores, infections, scarring, and a vicious cycle of pain.
Emotional strain: The awareness that others may not believe you only adds to isolation, frustration, and uncertainty.
Fibromyalgia is increasingly understood as a central nervous system disorder, in which pain and sensory signals are amplified or misinterpreted. Just as fibromyalgia patients experience widespread pain and hyperalgesia (heightened sensitivity to painful stimuli), they may also experience tactile misinterpretations like formication.
Consider these points:
Altered pain thresholds: In fibromyalgia, pain signals can arise spontaneously; likewise, sensations like crawling may emerge without an external cause.
Crosstalk in sensory pathways: Overlapping neural circuits for pain and touch might misfire, confusing tactile signals.
Central sensitization: The brain becomes primed to detect threats, turning up the volume on stimuli—real or imagined.
Data Supporting the Connection
Many fibromyalgia patients report complex sensory symptoms:
Itching without skin changes
Burning or tingling sensations (paresthesia)
Peripheral swelling, unexplained by visible inflammation
Though medical research into formication in fibromyalgia is still developing, existing studies point to its high prevalence and strong association with other sensory disturbances—reinforcing the theory of shared neural dysfunction.
Lack of large-scale studies on its prevalence and pathophysiology
Limited neuroimaging evidence to pinpoint brain regions responsible
No clear “standard of care”, leading patients to navigate trial-and-error treatments
Variability among individuals—what alleviates symptoms in one person may be useless for another
9. Emerging Research & Future Directions
The scientific community is steadily advancing understanding:
Neuroimaging studies are mapping abnormal sensory processing in fibromyalgia—hinting at targets for neuromodulation.
Peripheral neuropathy investigations reveal micro-nerve damage in many fibro patients, which may trigger formication.
Novel therapeutics, including low-dose naltrexone, cannabinoids, IVIG, and even brain stimulation (TMS, tDCS), are under scrutiny for their nervous-system modulating effects.
10. Empowering Yourself: Tips & Takeaways
Understand it’s real—Formication is not imaginary or psychological weakness.
Reduce self-harm—Trim nails, use moisturizers, and apply chill compresses.
Track episodes—A diary reveals triggers and aids medical planning.
Treat the nerves—Address fibromyalgia itself, not just individual symptoms.
Harness mind-body tools—Meditation, CBT, and relaxation techniques help regulate neural signals.
Advocate for care—Work with clinicians toward multidisciplinary treatment.
Stay hopeful—Research progresses, and many fibromyalgia patients find relief with personalized strategies.
11. Stories from the Front Lines
To grasp the lived reality of formication, consider these patient-reported experiences (anonymized):
“It felt like ants were marching all over my arms. I’d wake up in the middle of the night scratching until I bled. Nothing calmed it—no coconut oil, no antihistamine. Finally, gabapentin helped me get through the night.”
“Doctors called me paranoid, but I knew I wasn’t going crazy. Writing in my journal, I realized every episode followed heavy coffee or my PMS week.”
Sleep hygiene, relaxation routines, possible sleep meds
Skin Damage
Scratching leads to wounds and potential infection
Nail care, soothing compresses, monitor lesions, treat promptly
Emotional Distress
Anxiety, helplessness, fear of being misunderstood
Support groups, clear communication, stress reduction tactics
Doctor-Patient Misalignment
Central nature complicates understanding
Education, documentation, advocate for neuro/derm care and biopsies if necessary
13. Final Thoughts: You Are Not Alone
Dealing with fibromyalgia is already a full-time struggle—juggling pain, fatigue, “fibro-fog,” and emotional ups and downs. To add formication—sensations of ants, worms, or bugs crawling on your skin—often unmasks profound frustration. But the sensation is not random or imagined—it is a symptom of nervous system chaos, not a character flaw.
By acknowledging its connection to fibromyalgia, documenting episodes, advocating for nerve-directed treatments, and adopting skin-friendly and mind-body measures, you can gain control, reduce episodes, and protect your well-being.
Further Resources & Reading
Fibromyalgia research foundations—offer patient-oriented guidance and clinical trial listings
Neurosensory and neuroimaging journals—for emerging insight into tactile hallucinations and central sensitization
Support communities—both local and online—for shared strategies, empathy, and hope
Final Reflections: Rewiring the Body Through Tissue Healing
Fascia may not be visible to the naked eye, but it speaks volumes through the language of sensation. In fibromyalgia, its voice is often muffled—drowned out by pain pills and misunderstood diagnoses. But when we listen closely, fascia may hold the key to unraveling the chronic pain that shadows so many lives.
No single therapy will be a silver bullet. Yet, through patient-centered, fascia-inclusive care, fibromyalgia sufferers can begin to stitch together a tapestry of healing—one strand of relief at a time.
Many fibro patients suffer from a condition called Costochondritis, apart from common symptoms of fibromyalgia. In this condition, wearing a bra becomes difficult and sometimes even becomes impossible because it causes pain in the rib cage and breasts. Wearing the right bra can reduce the pain significantly if you are suffering from Costochondritis.
Inflammation of the cartilage that links the ribs to the breast bone is Costochondritis. It is very sudden and causes immense chest pain, much of fibromyalgia pain begins with this pain. Is the pain mildly irritating or it is extremely irritating, this all depends on the amount of inflammation, patients suffer from. Some patients describe what they go through as burning, stabbing, or aching pain. Some patients suffer from a complex chain of pain that they even relate to a heart attack.
In this condition, it is a painful task to put on tight clothing which compresses the ribs and needless to say an underwear bra. To reduce the pain wearing a comfortable bra is necessary to get rid of breast and ribcage inflammation but many women do not do this. However, when needed, it is best to wear something not too tight, in a comfortable fabric, and easy to wear and remove. Here are some tips for the selection of the right bra:
Seamless bra types are ideal as they prevent edgings from pressing against the skin.
Prevent that type of fiber that brushes against the skin and causes pain by avoiding anything textured like lace, tulle, or fabric with embroidery.
Best bra styles for every size
Soft cup bras: these bras offer good support for women of all sizes. Choose something with wilder shoulder straps as they won’t dig into the skin like the thinner ones do. A front closure design would also reduce the pain of putting on and removing the bra.
Sports bras: these bras can be very easy and comfortable as they give support to women of all sizes. Opt for something softer and with a wider stretch to prevent squeezing your ribcage and causing pain.
Bralettes: for smaller-sized women, a bralette might work in a good way. They are usually made with soft cups and are mildly comfortable.
Bandeaus: it is another good option for small and medium-sized women because bandeaus will sure that no wires or edges would press against the skin.
Dysphagia is a medical term that means that a patient has difficulty swallowing. There are a number of different conditions that can cause dysphagia. And someone who suffers from dysphagia often finds that it makes life very difficult. Depending on their condition, swallowing can be very painful, which makes eating and getting enough nutrition a challenge.
And what’s even more alarming is that many people with fibromyalgia report having problems with dysphagia.
So, what are some of the things that can cause dysphagia? Is there a link between the condition and fibromyalgia? And what can you do to treat it?
There are a number of different things that can cause dysphagia. Anything that interferes with the complex system of nerves and muscles that control the esophagus can make swallowing difficult. But some of the most common causes are:
Achalasia– a condition that causes the muscles in the esophagus to constrict.
Diffuse Spasm– a condition where the muscles spasm uncontrollably, usually after swallowing.
Esophageal Stricture– a narrowing of the opening of the esophagus caused by scar tissue or tumors.
Gastro-Intestinal Reflux Disease (GERD)– The gradual destruction of the tissue in the esophagus caused by acid from the stomach washing up into the esophagus.
Dysphagia can also occur without any obvious source. But whatever the cause, the symptoms are often similar. The most common symptoms are difficulty swallowing, pain in the throat, frequent heartburn, a hoarse voice, and regurgitating food you’ve already eaten.
In most cases, dysphagia isn’t dangerous. But it can lead to dramatic weight loss and can be life-threatening if it causes you to regurgitate food into the lungs.
And while we don’t always know what causes the condition, we do know that it is abnormally common in people with fibromyalgia.
A study by the National Institute of Health in the United States determined that a significant number of patients with fibromyalgia reported problems with swallowing. Patients in the study reported suffering from dysphagia at a rate 40% higher than people without fibromyalgia.
Unfortunately, the reason this sort of symptom is common in people with fibromyalgia remains a mystery. There’s so much that we don’t know about how fibromyalgia works, including why it would cause dysphagia. But we can speculate on a number of possibilities.
People with fibromyalgia often experience muscle weakness. This weakness could explain why they suffer from dysphagia. The muscles that control the process of swallowing may be affected by the general weakness caused by fibromyalgia.
In addition, we know that people with fibromyalgia have problems with their nervous system. An NIH study found that patients with fibro had significantly more neurological abnormalities than a control group. If fibromyalgia is a condition that affects the nervous system, as many doctors suggest it is, then it could be causing a breakdown between the nerves that control the esophagus and the brain.
This would explain why people with fibromyalgia have a hard time swallowing. Their brain can’t control the muscles in the esophagus as they normally would. But until we know more about the condition, we can’t say for sure what the link is. Luckily, there are some things you can do to treat the condition.
The first step in treatment is a diagnosis. The most common way to diagnose the condition is with an imaging test, like a barium X-ray. Essentially, the patient drinks a contrast material – barium- which coats the esophagus and makes it easier to see on the X-ray. The doctor can then examine the image to see if your esophagus is expanding correctly. And this examination can also be done with an endoscopic camera.
Your treatment will depend on what’s causing the condition. If the condition is caused by weakened muscles, there are a number of exercises you can do to strengthen the muscles. And you can learn different swallowing techniques to compensate for the weakened muscles. Your doctor will be able to advise you on what to do.
If the treatment is caused by muscle constriction in the esophagus, there are a number of medications that can help relax the muscles. In addition, a surgeon can perform a procedure to dilate the muscles and force them to relax. Finally, a surgeon can remove portions of the esophagus to widen the space for food to pass through.
If you’re experiencing difficulties swallowing, it’s always a good idea to see a doctor. They will be able to give you advice on the best course of treatment.
Light and noise sensitivity in fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS) have been scientifically established since the early 1990s, but they’re still underrecognized and rarely make symptoms lists. Rest assured that you’re not alone in experiencing this symptom!
When I used to take my kids to daycare, some mornings the noise would hit me like a brick wall. In an instant, I’d have pain, nausea, dizziness, trembling, and a looming panic attack.
More than once, I had to call in sick as a result of it. I’ve had similar experiences with bright or flashing lights, or with visual chaos in general.
We don’t know the causes of light and noise sensitivity, but they’re often called “generalized hypervigilance.” That means our bodies are constantly on high alert. It’s also a symptom of post-traumatic stress disorder.
Hypervigilance is beneficial for people in potentially dangerous situations, such as soldiers or police officers, because it speeds up to several processes and helps with crisis response.
In FMS and ME/CFS, however, hypervigilance overwhelms us. We don’t know why, but possibilities include:
So far, we don’t have research showing that specific treatments alleviate light and noise sensitivity in FMS and ME/CFS.
In people with PTSD, treatment for the anxiety related to generalized hypervigilance can include mental-health counseling and medications, especially antidepressants.
Supplements for anxiety and stress may help you cope better with light and noise sensitivity as well. Some people also benefit from treatments such as massage or acupuncture.
Light and noise sensitivity can have a huge impact on your life. You may avoid certain situations and even fear them, which increases anxiety. It can also contribute to social isolation, which is common in people with FMS or ME/CFS and can worsen depression.
Some work environments are difficult to endure. I used to be a television news producer, which meant sitting under a lighting grid in a room with dozens of TVs and ringing phones. I went from thriving in the chaos to having regular anxiety attacks. I decided to leave the job. Other people may be able to get reasonable accommodation to lessen the impact of this symptom.
You might be able to eliminate or avoid many sources of excess noise and light, but you probably can’t eliminate all of them. Several simple things can help you deal with light and noise sensitivity in your daily life:
If fluorescent lights bother you, lightly tinted sunglasses or a hat with a brim may help.
In a noisy environment, earplugs or listening to music on headphones may help some people.
Deep breathing and other relaxation techniques can help you get through episodes of sensory overload due to light and noise.
Teach your family and friends about the impact that light and noise have on you so they understand your requests to turn off lights or turn down the volume.
If your computer screen bothers you, try adjusting the brightness and contrast.
In 2014, a survey of more than 1,300 fibromyalgia patients by the National Pain Foundation and National Pain Report found medical marijuana is more effective than Lyrica, Cymbalta, or Savella, the three drugs approved by the Food and Drug Administration to treat the disorder. (If you’re curious about the effectiveness of Lyrica, Cymbalta, and Savella, then you might be interested in my post, “Why your fibro meds aren’t working.”)
There’s growing anecdotal evidence that marijuana relieves fibromyalgia pain, but actual research is still scant. Cannabis remains a Schedule I controlled substance in the United States, making it difficult for researchers to study the plant’s pain-relieving properties. To date, there have been less than a handful of small studies using cannabis or its derivatives to treat fibromyalgia. Most of those have shown it to be beneficial, especially for pain relief.
But why does cannabis seem to work so well? Dr. Ethan Russo, medical director of PHYTECS, believes fibromyalgia’s multifaceted symptoms may be caused by a deficiency in the body’s endocannabinoid system (ECS), a condition he calls Clinical Endocannabinoid Deficiency (CED). Maybe the reason cannabis is so effective is that it’s simply supplementing what the body needs – similar to how people take a supplement to treat vitamin D or B12 deficiency.
Russo explores the evidence behind his hypothesis in a soon-to-be-published review entitled, “Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes.” While his idea is still theoretical, there is some early research indicating he may be onto something.
The ECS is made up of cannabinoid receptors within the brain, spinal cord, nerves, gut, organs, and other locations in the body. It helps the body maintain homeostasis and is involved in a number of physiological processes, including pain sensation, mood, memory, and appetite, among others. The body naturally makes endocannabinoids – the same kinds of endocannabinoids found in cannabis – that feed the ECS and keep it functioning.
Fibromyalgia causes symptoms throughout the body, with the primary ones being a pain, fatigue, cognitive and sleep difficulties. Certain conditions, like irritable bowel syndrome (IBS) and migraine, are extremely common among those with fibromyalgia – so much so that Russo believes they may all be connected to an ECS deficiency.
His theory makes sense. The ECS plays a role in so many of the body’s major systems, so if it was indeed malfunctioning, that would account for why fibro sufferers have such varied symptoms. Supplementing the ECS with cannabinoids from the cannabis plant would, in theory, relieve symptoms because the deficiency is being treated.
Russo first posited that fibromyalgia, IBS, and migraine may be caused by an ECS deficiency back in 2001. (Click here to read his first review on the subject.) His latest review gives an update on new research that supports ECS deficiency as a possible culprit for fibromyalgia, IBS, and migraine.
“Additional studies have provided a firmer foundation for the theory,” he writes in the review, “while clinical data have also produced evidence for decreased pain, improved sleep, and other benefits to cannabinoid treatment and adjunctive lifestyle approaches affecting the endocannabinoid system.”
CED is based on the premise that many brain disorders have been linked to neurotransmitter deficiencies. For example, dopamine has been implicated in Parkinson’s disease, and serotonin and norepinephrine have been associated with depression.
“If endocannabinoid function were decreased, it follows that a lowered pain threshold would be operative, along with derangements of digestion, mood and sleep among the almost universal physiological systems sub-served by the ECS,” Russo writes.
That’s a mouthful, but essentially it means if the ECS isn’t properly working, then it could account for the pain, sleep, digestive and other issues so common among fibromyalgia patients. Adding cannabinoids to the body through the use of cannabis may help to bring the ECS back into balance.
“It’s a key in a lock in your body that exists for a reason,” explains Dr. Jahan Marcu, chief scientist with Americans for Safe Access. “We send in cannabinoids to activate this system that’s supposed to be working. It’s a sort of care and feeding of the ECS so it can do its job.”
The best evidence for CED comes from an Italian migraine study, which found reduced levels of an endocannabinoid known as anandamide in patients with chronic migraines versus healthy controls.
“Reduced [anandamide] levels in the cerebrospinal fluid of chronic migraine patients support the hypothesis of the failure of this endogenous cannabinoid system in chronic migraine,” read the study.
Unfortunately, the Italian study will probably never be repeated in the United States because it required risky and invasive lumbar punctures.
In the gut, the ECS modulates the movement of food along the digestive tract, the release of digestive juices to break down food, and inflammation.
Cannabis has long been used to treat digestive issues and was one of the first effective treatments for diarrhea caused by cholera in the 19th century.
“Unfortunately while many patient surveys have touted the benefit of cannabinoid treatment of IBS symptoms, and abundant anecdotal support is evident on the Internet, little actual clinical work has been accomplished,” Russo writes.
A few studies using marijuana for fibromyalgia have had positive results. Overall, marijuana has been found to decrease pain and anxiety, and improve sleep and general well-being.
“There is actually some evidence that the levels of at least one endocannabinoid (anandamide) increase in the circulation of patients with fibromyalgia,” says Prof. Roger G. Pertwee from the University of Aberdeen in Scotland. “There is also considerable evidence that anandamide is often released in a manner that reduces unwanted symptoms such as pain and spasticity in certain disorders. … It is generally accepted that THC, the main psychoactive constituent of cannabis, can relieve pain, including neuropathic pain for example, by directly activating cannabinoid receptors. … Some non-psychoactive constituents of cannabis have also been found to relieve signs of pain, at least in animal models.”
For anecdotal evidence, Russo cites the National Pain Foundation/National Pain Report survey in his review, saying, “The results of the survey strongly favor cannabis over the poorly effective prescription medicines. These results certainly support an urgent need for more definitive randomized controlled trials of a well-formulated and standardized cannabis-based medicine in fibromyalgia inasmuch as existing medicines with regulatory approval seem to fall quite short of the mark.”
More research needs to be done to either prove or disprove CED’s existence.
“What we really need is randomized controlled trials to look at this more carefully, and that’s the only kind of evidence that the [Food and Drug Administration] and most doctors are going to find acceptable in the end,” Russo says.
MRI and PET scans are not yet able to detect endocannabinoid levels in living patients, but as technology advances, that may become a possibility. The ability to actually test endocannabinoid levels in fibromyalgia patients and compare those against healthy controls would help to confirm Russo’s theory.
“We’re on the edge of having that capability,” Russo says. “It’s in my plans to look at this type of thing in the future.”
Gluten has been liked to more than 55 diseases and is often called the ‘big masquerader’. The reason for this is that the majority of symptoms of gluten intolerance are not digestive in nature but rather neurological such as pain, cognitive impairment, sleep disturbances, behavioral issues, fatigue, and depression.
Adrenal Fatigue: Adrenal fatigue is a result of chronic stress whether real or perceived. Chronic pain is a stress to the adrenal glands, though typically not the initial adrenal stressor. The initial stressor is usually something such as food intolerances, Candida, mercury toxicity, vitamin deficiencies, or mycotoxins. The goal is to support the adrenals while searching for the root cause of the stress and correct it.
Thyroid: More than half of the people with thyroid issues have no idea they have one and 90% of these have hypothyroidism or an underactive thyroid gland. It is vital that your doctor check six different blood markers to measure your thyroid gland’s function, and it’s imperative that your doctor use the optimal levels rather than the standard reference range when assessing and diagnosing thyroid disorders.
Candida Overgrowth: Candida is a fungus or yeast, and a very small amount of it lives in your intestines. However, when overproduced, Candida breaks down the wall of the intestines and penetrates the bloodstream, releasing toxic byproducts into your body causing a host of unpleasant symptoms such as brain fog, fatigue, digestive issues, and pain. A lot of fibromyalgia patients have had Candida overgrowth.
Glutathione Deficiency: Glutathione, a molecule, is the most critical part of our body’s detoxification system. Glutathione gets recycled in our body unless our toxic burden gets too high or we lack GSTM1 and GSTP1, the enzymes needed to recycle and produce glutathione. Taking a glutathione supplement or the precursors (NAC, alpha-lipoic acid, milk thistle) often helps dramatically with fatigue.
Small Intestine Bacterial Overgrowth (SIBO) and Leaky Gut: There are more bacteria in us and on us than there are of our own cells. When these bacteria get out of balance through the use of antibiotics or a sugar-rich diet we can lose our ability to digest and absorb nutrients, particularly B12. Gluten can cause SIBO and leaky gut and SIBO and leaky gut can lead to gluten and other food intolerances. It’s a catch-22 and a vicious cycle. You must first heal the gut in anyone with fibromyalgia or any chronic illness.
Mycotoxins: Mycotoxins are very toxic substances produced by toxic molds. Only about 25% of the population carries the genes to be susceptible to the effects of mycotoxins. Conventional environmental mold testing only tests for levels of mold spores and does not test for mycotoxins.
MTHFR Mutations: This is a genetic test you can get through any conventional lab. The more mutations you have in the MTHFR gene the less able you are to methylate and detoxify, particularly toxins such as mercury and lead. The more mutations you have in this gene the higher your requirements for methyl-B6, methyl-B12, and folinic acid in order to keep your detoxification pathways working properly.
Vitamin Deficiencies: Magnesium, vitamin D, and B12 deficiency are the most common vitamin deficiencies in those who have been diagnosed with fibromyalgia. The best way to measure magnesium is a red blood cell (RBC) magnesium level, which can be ordered by your conventional doctor.
As you can see from the above list, many of these causes are interrelated and often there is no single root cause of fibromyalgia or any chronic illness. It is a combination of several or possibly all of the above.
Are the eyes the window to whatever’s going wrong with the brain in fibromyalgia? Research published in 2015 and 2016 suggests that it just might be.
Fibromyalgia is widely believed to be a condition of the central nervous system, which includes the brain and spinal column. It also includes the eyes and the structures that help our brains interpret what we see.
Chief among these structures is the optic nerve, which is similar to a cable made up of many smaller fibers.
Among them is a layer of nerves called the retina nerve fiber layer (RNFL).
Those nerve fibers are of special interest to researchers because of other recent work that’s uncovered dysfunction of the small nerve fibers. It suggests that, in people with fibromyalgia, small-fiber neuropathy (nerve damage) may be responsible for at least some of the pain.
In two studies, Spanish researchers have also discovered evidence of neuropathy in the small fibers of the eye.
In the study published in 2015, researchers looked at blood flow to the optic nerve and the RNFL. Blood flow, also called perfusion, is hypothesized to be irregular in several regions of the brains of people with fibromyalgia.
Researchers examined and took photographs of the eyes of 118 people with this condition plus 76 healthy people in the control group.
The photos were then analyzed with special software. The researchers concluded that the fibromyalgia eyes did in fact show low perfusion rates in several sectors, but the only significant difference was in certain RNFL.
The study published in 2016 built on that research, involving many of the same researchers. This time, they included 116 people with fibromyalgia and 144 in the control group.
They found:
a significant decrease in the RNFL in fibromyalgia compared to controls
a thinning of multiple structures in the eye
greater optic nerve thinning in those with severe fibromyalgia than in those with a milder case
greater optic nerve thinning in subgroups without depression than in those with depression
Before now, fibromyalgia has been considered non-neurodegenerative, meaning that no biological structures were being damaged or destroyed as they’re known to be in other neurological diseases such as multiple sclerosis or Alzheimer’s disease.
However, this research suggests that fibromyalgia may, in fact, involve some neurodegeneration in structures inside the central nervous system.
This, combined with earlier research on small nerve fiber damage in the skin, could mean that the degeneration is not confined to the central nervous system but may extend to the peripheral nervous system, which includes the nerves in the limbs, hands, and feet.
Fibromyalgia has always posed problems for doctors. We have pain, but no obvious cause. If this research is accurate, which we won’t know until it’s been replicated, it could mean that our pain comes from a very understandable source. After all, neuropathic pain has been recognized for a long time.
Suddenly, it makes our “mysterious” pain not mysterious at all.
On the other hand, it opens new doors for questioning. If we have damaged nerves, then why? What is causing the damage?
Possible candidates could include autoimmunity, which would involve the immune system going haywire and attacking the nerves as if they were bacteria or viruses, and problems with how the body uses substances that grow or maintain nerves.
Researchers have long speculated about possible autoimmunity in fibromyalgia, but so far we don’t have solid evidence pointing toward it. Now that researchers have discovered actual damage, they may gain better insight into where to look for autoimmune activity.
They may also be able to pinpoint shortages or inefficiencies in how nerves are maintained.
When it comes to diagnostic tests, it’s too early to say whether abnormalities in the eye could lead to a more objective test than we currently have. If so, it would be a major advancement in how fibromyalgia is detected.
Because the thinning was worse in more severe cases, it could provide a marker for doctors to monitor treatments as well as progression.
It’s also possible that these discoveries could lead to targeted treatments.
We won’t know the full impact of this research for some time, as any advancement in diagnostics and treatments would have to come after further research either confirms or contradicts these findings.
I’m a fairly open person when it comes to physical and mental illness, but I can also be very reserved, especially about my chronic pain and fatigue. It’s not because I don’t want to share about what’s going on with me, but because I don’t want people to think I’m a “whiner” or “attention seeker.” I am neither of those things. In fact, I’m quite the opposite.
A lot of people know I have fibromyalgia. What they don’t know is the reality of what I deal with. They see a positive, silly, young 25-year-old woman on the outside, but they don’t realize how much pain I’m in, or how badly my anxiety is affecting me. I don’t think people really understand the intensity of my conditions. I’ll admit that part of it is my fault, for showing only the good parts of my life on social media, but showing the not-so-good parts can sometimes come off as attention seeking. I don’t want attention, I want my conditions to stop being stigmatized. I don’t want pity, I want people to understand these illnesses.
When you tell someone you’re in pain, they don’t really take it very seriously. They usually think that you have a typical headache or backache. They don’t realize that your whole body is experiencing aches, stabbing pain, needles, numbness, or oftentimes a burning sensation. They also don’t realize that the clothing you’re wearing, or the cloth chair you’re sitting on could be causing you pain as well. People with fibromyalgia have sensitives to certain fabrics and materials. Some of us (including myself) feel pain in our organs. I’ve had ovarian pain for years and didn’t know what it was until I was diagnosed with fibromyalgia.
Our pain is often unbearable and can cause difficulties in everyday situations. When I’m going through bad flare-ups, I am sometimes late to work. It seems like no matter how early I wake up, it takes me 30 minutes to an hour to get out of bed because my body is stiff, my hips are locked, and my hands ache. Carrying a grocery basket can cause my hands and elbows to tense up, opening jars is sometimes impossible, household chores can take everything out of you, and the list could go on.
Speaking of being late to work, fatigue is another reason it’s so difficult to get out of bed. I could have had the best sleep of my life, but it will feel like I didn’t sleep a wink. For me, chronic fatigue is one of the most difficult symptoms. There have been days I’m nervous to drive long distances because the sun causes really bad fatigue. I work a desk job, but by midday, I feel like I’ve been doing hard labor, and all I want to do is go home and sit on the couch. And good luck trying to schedule anything with me after work. I’ll just be too exhausted to do anything. If you’re able to get me to hang out with you on weekdays, it’s probably because no matter how tired I am, I really need your company.
This is the last symptom I will touch on. Brain fog is a bitch, to say the least. Completely forgetting a conversation you had yesterday, having to pause mid-sentence because you forgot what you were saying, or stopping a conversation altogether because you can’t think of the right words to use. This is the most embarrassing symptom of fibromyalgia. Feeling incompetent is incredibly frustrating and heartbreaking. I often wonder if people are judging me because of this. I find at times, I can’t even remember how to spell a word when I’m typing. I proofread my text messages, emails, and social media posts multiple times before pressing the “send” or “submit” button. The embarrassment of brain fog causes me so much anxiety. I just want people to know can’t control the way my brain works sometimes.
It’s very common that individuals with fibromyalgia will struggle with different symptoms than others. All symptoms are different for everyone, so it’s difficult to explain to doctors what your symptoms are. Chronically ill patients seem to know about their illness than professionals, and that can be hard when it comes to medications and treatments. We’re all in this together, and we need support and understanding from the people and loved ones in our lives.
I hope this sheds some light on this awful illness. If you know someone living with fibromyalgia, go give them a (gentle) hug and ask what you can do to help them. Just being there to listen could mean the world!
Social Security has published a ruling that helps define when applicants with fibromyalgia should be granted disability benefits.
A lot of candidates for Social Security disability benefits the ones who apply based on fibromyalgia get rejected. The part of the motive was that Social Security does not have a disability “listing” for the condition. (Social Security’s disability listings offer the conditions needed for numerous different impairments to be sanctioned as disabilities.) The Social Security Administration (SSA) printed a ruling in 2012 to address the issue, providing directions to disability claims surveyors and administrative law judges (ALJs) regarding how to evaluate fibromyalgia circumstances. This ruling ought to help reduce the number of fibromyalgia applicants who are rejected at the preliminary application phase and go on to file an appeal and ultimately win disability welfares.
Despite that, a lot of fibromyalgia patients will continue to be denied welfares. If you are applying for disability constructed on fibromyalgia, it just benefits to know that how the SSA views this specific impairment (known as fibromyositis).
Usually, when a disability claims examiner got a situation where the motive for disability was just fibromyalgia, the point of view for an initial endorsement was poor. Disability examiners usually presented slight weight to an entitlement of fibromyalgia unless there was one more condition involved, for instance, degenerative disc disease or arthritis, the one that was more possible to come with objective proof of the disease just like x-rays. Why was it? Part of the problem has to do with the nature of fibromyalgia—its signs are mostly particular and its causes are not understood. Since its symptoms differ from person to person, and for the reason that the medical career had not figured out fibromyalgia’s reasons, disability examiners were by no means certain how to categorize such circumstances. As the medical profession has started to recognize fibromyalgia better, Social Security has established new standards for evaluating fibromyalgia.
As to be selected for disability welfares, you need to have an impairment recognized by medical proof for instance medical “signs” of the disease or illness and lab tests. In other words, your impairment cannot be established merely by your reports of your symptoms. This is known as the necessity of having a “medically determinable impairment” (MDI)—the SSA has to understand medical signs of an impairment that might more likely be expected to produce your symptoms. Verifying this can be challenging with fibromyalgia, as the illness is generally categorized by subjective reports of extensive pain, dizziness, tenderness in the muscles, joints, and soft tissues, fibro fog, and fatigue.
Luckily, in July 2012, Social Security allotted a ruling clarifying when fibromyalgia would bring into being as a medically determinable impairment. The ruling directs statements examiners and judges to count on conditions allotted by the American College of Rheumatology (ACR) to define whether a candidate has fibromyalgia, and so has an MDI.
To be considered an MDI first, the patient would have proof of chronic extensive pain, with pain in the back, chest, or neck and the doctor must have governed out other diseases (hypothyroidism, such as lupus, and multiple sclerosis) over the procedure of lab tests or x-rays. Also, the patient must have one of the following:
1. Tender arguments in at least 11 of 18 tender argument regions of the body, with tender arguments befalling on both sides of the body and both above and beneath the waist. You can get a list of the tender arguments in the SSA’s latest ruling on fibromyalgia.
2. Repetitive manifestations of six or additional fibromyalgia symptoms, mainly cognitive, fatigue, or memory issues (fibro fog), anxiety, non-restorative sleep, depression, or irritable bowel syndrome (IBS). Other likely symptoms consist of abdominal pain, headache, muscle weakness, seizures, Raynaud’s phenomenon, and dizziness.
The claims examiner will evaluate your medical records to see if they comprise proof of the above criteria. The examiner will read the doctor’s notes on your complaints of fatigue, pain, and possible cognitive complications. To evaluate the reliability of your complaints, the claims examiner can ask your doctor to offer information about the amount and time period of your impairments, his or her judgment of how well you are capable to function, what treatments were done, and whether they were supportive and had side effects, and how long the doctor believes your capability to function to be restricted. The longer your medical record contains proof of fibromyalgia symptoms and treatment, the better.
In case SSA defines that you have the medically determinable impairment of fibromyalgia, Social Security’s assessment is not done; actually, it has just started. The SSA will possibly create a “residual functional capacity” (RFC) assessment for you to decide if there is any work you can do, with your past work. RFC assessment is an estimation of your capability to perform numerous exertional stages of work; let’s say, if you can’t lift more than ten pounds, you will be provided a sedentary RFC. The SSA bases your RFC on your medical records, views from specialists and doctors, and statements from you and from your family members. In evaluating your RFC, the SSA will be dependent on your doctor’s view as to your abilities, just like how long you can stand, walk, and sit, how much you can lift, and how well you can focus and remember guidelines. These practical restrictions are the key to showing the SSA why you can’t work.
When making your RFC, the SSA will match it to the kinds of jobs vacant for somebody with your RFC level and restrictions. If the RFC rules out every job, though sedentary work, you will be considered disabled.
More likely in other cases, hiring a lawyer to request a rejection of welfares for fibromyalgia can surely benefit, as disability lawyers are aware of the Social Security decision on fibromyalgia (SSR 12-2p) and the modern court verdicts on when disability would be approved for fibromyalgia. This information can assist disability attorneys to find errors that were made by the judge or claims examiner in the disability determination and use them to your benefit.
Also, if just a primary care internist or physician gives you a fibromyalgia diagnosis, then try to make an appointment with a specialist; and a diagnosis made by a rheumatologist will be more reliable to a judge or disability examiner and will help your Social Security disability request or claim.
