Fibromyalgia symptoms can mask the presence ofchronicinflammatory disease affecting the joints of the pelvis and spine, according to new research.
The study, titled “Prevalence of Axial Spondyloarthritis Among Patients With Fibromyalgia: A Magnetic Resonance Imaging Study With Application of the Assessment of SpondyloArthritis International Society Classification Criteria,” was published in the journal Arthritis Care & Research.It highlights the importance of vigilant management of fibromyalgia symptoms by doctors and patients, taking into account the possible underlying presence of inflammatory disorders.
Unlike other rheumatologic diseases, fibromyalgia is non-inflammatory in nature, and recent reports suggest that it is caused by uncontrolled hyper-activation of the pain-associated nervous response.
Fibromyalgia patients can present a broad spectrum of symptoms, including chronic nocturnal back pain, morning stiffness, and disturbed sleep. However, these are also symptoms of an inflammatory condition called axial spondyloarthritis (SpA).
The spA is a chronic inflammatory condition involving the spine, pelvis, and surrounding joints. Although SpA and fibromyalgia are very different diseases, they can overlap and share similar symptoms.
Aiming to determine the incidence of SpA among fibromyalgia patients, a total of 99 patients with fibromyalgia underwent magnetic resonance imaging (MRI) evaluation for the identification of structural alterations common in SpA chronic inflammation1, such as bone erosion and spine deformations (sclerosis).
About 8% of patients presented symptoms of inflammation in pelvic joints, while 17% and 25% presented bone erosion and sclerosis, respectively. Despite the frequency of these symptoms, only 10% of fibromyalgia patients were positively SpA diagnosed,accordingto the Assessment of SpondyloArthritis International Society classification criteria.
“When approaching the clinical conundrum of differentiating between ‘pure’ fibromyalgia and those cases with an unsuspected underlying inflammatory disease, the physician must attempt to rely[on] onclinical judgment and on available diagnostictools,” the study’s authors, from medical centers in Tel Aviv, Israel, wrote.
Through blood tests that evaluate levels of a protein associated with inflammation, known as CRP, the authors found that the diagnosis of SpA was positively associated with increased CRP levels and physical function limitation. This result suggests that CRP could be used as a diagnostic tool for SpA among fibromyalgia patients.
“These results underscore the importance of recognizing the overlap between inflammatory and centralized pain in each patient and call for increased clinical vigilance in the process of differential diagnosis,” the authors concluded.
A diagnosis of fibromyalgia is often given when doctors are unable to find another cause for chronic widespread body pain. But many fibromyalgias suffers are often told the pain is all in their heads. Now, discoveries about the potential cause of fibromyalgia, along with a new test to diagnose fibromyalgia, could offer relief to millions — the vast majority of whom are women. If you have fibromyalgia, you’ve likely experienced frustration when trying to find a treatment that works to alleviate body pain, fatigue, brain fog, and more. And, you might experience the additional blow of family, friends, and even doctors telling you that your symptoms are psychosomatic.
“Fibromyalgia patients tend to be stressed, tense, anxious, ambitious, and sometimes depressed. Some fibromyalgia sufferers describe themselves as perfectionists,” Stanford Medicine reported. “They may also suffer from symptoms of irritable bowel syndrome or migraine or tension headaches. Physicians who dismiss their patient’s complaints as being ‘all in the head’ can also make symptoms worse.”
More and more evidence has emerged about how the body and brain work together, and how a communication breakdown between these two systems can contribute to chronic pain conditions. Researchers at Massachusetts General Hospital have identified an underlying condition that could play a role in illnesses like chronic fatigue, fibromyalgia, and irritable bowel syndrome, according to a study published in the journal Current Pain and Headache Reports. Additionally, another study published in the Journal of Evaluation in Clinical Practice reported that a new test could more effectively differentiate fibromyalgia from other chronic pain conditions.
New Screening Can Effectively Diagnose Fibromyalgia
The study from the Journal of Evaluation in Clinical Practice was conducted to help primary-care physicians become more skilled at correctly identifying fibromyalgia. According to the study, half of all primary-care providers from the U.S., Asia, and Europe did not know how to diagnose fibromyalgia. The screening method, which involves using Achilles tendon pressuring in tandem with an inquiry about widespread body pain, can help doctors determine if a chronic pain patient might have fibromyalgia in less than one minute.
Being able to get a fast and accurate diagnosis can save chronic pain suffers years of tests and uncertainty. “Because of the many different symptoms it may present, fibromyalgia can be challenging to diagnose,” Fibromyalgia News Today reported. “The process often takes two to three years and three to four evaluations by different medical teams to reach a correct diagnosis.”
If you’ve seen Gaga: Five Foot Two, then you know that Lady Gaga did not receive her fibromyalgia diagnosis for five years. This new screening method is meant to speed up that process. According to Fibromyalgia News Today the study used three clinical measures — blood pressure (BP) cuff‐evoked pain, digital palpation evoked pain, and a single question about “persistent deep aching” — to indicate fibromyalgia.
“The study found that patients with fibromyalgia showed significantly greater sensitivity to digital pressure and BP-evoked pressure pain compared to patients with chronic pain but no fibromyalgia,” Fibromyalgia News Today noted. “When questioned about deep ache, more fibromyalgia patients responded positively than the other groups of participants. Additional analysis showed that patients who had right Achilles tenderness and who endorsed the deep-aching question had an 11 times greater chance of having fibromyalgia.”
The study concluded that patients who receive a positive diagnosis need a follow-up exam to confirm whether or not they have fibromyalgia.
The Massachusetts General study found that something called small-fiber polyneuropathy — the impairment of small nerve fibers — is present in a variety of different diseases and often results in symptoms of burning and shooting pain. Fox 25 in Boston spoke to Dr. Anne Louise Oaklander, who was involved in the study and said that those who suffer from diseases like fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome might actually have a disease called small-fiber polyneuropathy, or SFPN, a disorder in which nerve cells found under the skin are attacked by the body’s immune system. One of the reasons it’s so hard to diagnose is that even though patients suffer from widespread pain, no one can see it — but that’s now changing.
She discovered that drugs called immunomodulators — medications used to help regulate or normalize the immune system — can be effectively used to treat SFPN in some patients, which is offering relief to long-time sufferers. “It’s pretty routine that I have patients who break down and cry when they get an answer for the first time to something that’s been disabling them for years or decades,” Oaklander said, adding that SFPN is diagnosable by biopsy.
The study described symptoms of SFPN, and they’re pretty on point with what many people with fibromyalgia, IBS, chronic fatigue, and undiagnosed chronic pain report. “Many individuals report the gradual onset of distal symptoms that include vague disturbances of sensation in the feet. These symptoms may include the feeling of a wrinkle in a sock that cannot be removed or of small pebbles or sand in the shoe. Others may report a cold-like pain, tingling or a pins and needles sensation,” the study detailed.
Other, more severe, symptoms include persistent burning pain and transient electric shock-like pain with symptoms worsening during periods of rest and at night. Additionally, “Patients with small fiber neuropathy frequently complain that the bedsheets are exquisitely painful, and therefore, wear socks or use ‘foot tents’ to keep the sheets from making physical contact with the feet.”
Harvard’s newspaper, the Harvard Gazette, reported that as many as half of all people diagnosed with fibromyalgia may actually have SFPN, which could be good news because, unlike fibromyalgia, SFPN is treatable with immunomodulators. Because the two diseases are so similar, it can be difficult to tell them apart. And, while not everyone who has fibromyalgia has SFPN, those who do may find some relief with medication. What’s more, because SFPN can be diagnosed with a biopsy, patients can finally find out one way or the other if they have it.
Overall, these two discoveries offer hope for chronic pain sufferers who often feel like they’re fighting an invisible war. Having more options to diagnose and treat chronic pain is a positive step on the road to healing.
According to a study titled “Lengthened Cutaneous Silent Period in Fibromyalgia Suggesting Central Sensitization as a Pathogenesis” and published in the journal PLOS One, dysfunction in spinal cord processing may be responsible for pain in fibromyalgia (FM) patients.
Among other side effects, Fibromyalgia is portrayed by chronic widespread pain, but the root cause that is responsible for chronic pain in FM is still vague. A recent study has shown that for fibromyalgia pathogenesis, central pain amplification is key, FM pathogenesis also known as “central sensitization” is a process that is characterized by augmented pain and sensory processing in the spinal cord and brain.
The cutaneous silent period (CSP), a spinal reflex interceded by A-delta cutaneous afferents that are used to evaluate pain processing in both the central and peripheral nervous systems, between FM patients and normal healthy controls were compared by the researchers. The amount of people that were analyzed was 24 fibromyalgia patients (diagnosed according the 1990 American College of Rheumatology classification system) and 24 healthy controls of same age and sex. CSP was checked from the abductor pollicis brevis muscle which is present in the hand between the wrist and the base of the thumb by using standard electro diagnostic equipment, along with patients’ parameters in which statistic information, number of tender points, visual analog scale and fibromyalgia affects surveys scores were included.
These findings suggest that in the central nervous system, fibromyalgia is linked with pain modulation mechanisms dys-functioning. Also, according to researchers study, there was no correlation between CSP and clinical parameters like VAS score, K-FIQ score, age, and height, which postures questions in the matter of whether to utilize CSP to survey ailment seriousness. As a matter of fact, researchers emphasize that extra reviews are required to additionally assess the relationship between CSP parameters and clinical information.
The authors write in their report, “In conclusion, dysfunction of supraspinal control may be responsible for pain in FM, giving additional proof that central sensitization underlies the pathogenesis of the disease,”
Is there a more effective way to treat fibromyalgia?
A Canadian researcher think he has uncovered one. Ian Gilron is the Director of Clinical Pain Research, Professor of Anesthesiology, and Biomedical Sciences, and Faculty in the Centre for Neuroscience Studies at Queen’s University in Kingston, Ontario, Canada
The results of a trial suggest that combining pregabalin (Lyrica), an anti-seizure drug, with duloxetine (Cymbalta), an antidepressant, can safely improve outcomes in fibromyalgia, including not only pain relief, but also physical function and overall quality of life. Until now, these drugs have been proven, individually, to treat fibromyalgia pain.
“Previous evidence supports added benefits with some drug combinations in fibromyalgia,” says, Dr. Gilron. “We are very excited to present the first evidence demonstrating superiority of a duloxetine-pregabalin combination over either drug alone.”
Fibromyalgia was initially thought to be a musculoskeletal disorder. Research now suggests it’s a disorder of the central nervous system – the brain and spinal cord. Researchers believe that fibromyalgia amplifies painful sensations by affecting the level and activity of brain chemicals responsible for processing pain signals.
“The condition affects about 1.5 to 5 per cent of Canadians – more than twice as many women as men. It can have a devastating on the lives of patients and their families,” explains Dr. Gilron. “Current treatments for fibromyalgia are either ineffective or intolerable for many patients.”
This study is the latest in a series of clinical trials – funded by the Canadian Institutes of Health Research (CIHR) – that Dr. Gilron and his colleagues have conducted on combination therapies for chronic pain conditions. By identifying and studying promising drug combinations, their research is showing how physicians can make the best use of current treatments available to patients.
“The value of such combination approaches is they typically involve drugs that have been extensively studied and are well known to health-care providers,” says Dr. Gilron.
This new research was published in the journal Pain.
Dr. Gilron and his research team at Queen’s are members of the SPOR Network on Chronic Pain. The national network, funded under Canada’s Strategy for Patient-Oriented Research, directs new research, trains researchers and clinicians, increases access to care for chronic pain sufferers, and speeds up the translation of the most recent research into practice.
Lyrica (pregabalin) is an FDA-approved drug For Fibromyalgia Pain Relief. Fibromyalgia is a chronic disorder thatcauses long-term, worldwide muscle pain and tenderness, trouble sleeping, and overwhelming tiredness. this drug is not an antidepressant.The medicine has long been used to reduce nerve pain in patients with shingles and diabetic neuropathy. It is also used to treat partial seizures.
How Does Lyrica Work for Fibromyalgia Pain Relief? Fibromyalgia pain is consider to be brought on by nerve related changes which cause nerve cells to fire off too many signals. This renders a person overly sensitive to stimuli that are normally not painful.Scientists aren’t exactly sure how Lyrica improves symptoms and For Fibromyalgia Pain Relief. but laboratory research suggests Lyrica helps decrease the number of nerve signal and as a result calms down overly sensitive nerve cells. This appears to alleviate pain in patients with Fibromyalgia.
How Do You Take Lyrica for Fibromyalgia Pain Relief?When used for fibromyalgia, Lyrica is a capsule that is usually taken in divided doses twice a day. Doses range from 150 milligrams to 450 milligrams a day. Your doctor will determine the best dose for you. If you miss taking one capsule, you should take it as soon as possible — unless it is close to the time when you are supposed to take the next one. Never take two or more at the same time.You should not suddenly stop taking this medicine. Doing so can give you a headache, upset stomach, diarrhea, and sleeping difficulties. If you wish or need to stop taking the medicine, your doctor will tell you how to slowly reduce your dose over time.
The Benefits of Lyrica: Lyrica can quickly reduce pain and for Fibromyalgia Pain Relief, improve sleep, and help some people with fibromyalgia function better and get back to their daily routines. In studies, some patients reported significantly less pain after taking Lyrica for only one week. Lyrica, however, may not help everyone with fibromyalgia.
Before You Take Lyrica for Fibromyalgia Pain Relief: Always make sure your doctor knows about all the other medications you are taking. This includes over-the-counter drugs, as well as herbs and supplements. Some prescription medicines may interact with Lyrica and may lead to dangerous side effects. Such drugs include:
1. Blood pressure medicines called ACE inhibitors; taking Lyrica with these medicines increases your chance for swelling and hives.
2. Diabetes medicines Avandia (rosiglitazone) or Actos (pioglitazone); if you take these drugs with this drug, you may have a higher risk for swelling or weight gain.
3. Narcotic pain medicines (such as oxycodone), anxiety medicines (such as lorazepam), and tranquilizers; combining these drugs with this drug increases your chances for dizziness and sleepiness.
4. Sleep medicines make you nod off, and Lyrica can cause drowsiness. Combining the two can be dangerous.
Do not drink alcohol when on Lyrica. Doing so can increase Lyrica’s side effects and make you dangerously sleepy.
Also tell your doctor if you have any other medical conditions, including:
1. Bleeding disorders or low platelet counts
2. Heart problems
3. Kidney problems or if you receive kidney dialysis (a lower dose of Lyrica is needed if you have kidney problems)
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.
Did you have a gynecologic surgery, such as a hysterectomy, in the few years before you developed fibromyalgia?
It’s a trend some people have noticed, and a study published in 2015 shores up the link between these types of surgeries and fibromyalgia onset. It also provides further evidence for an association between fibromyalgia and common overlapping conditions that are gynecologic, endocrine, or autoimmune.
Findings
In the study, researchers reviewed charts of 219 women with fibromyalgia and 116 women with non-fibromyalgia chronic pain. Specifically, they examined the time between illness onset and gynecologic surgery as well as the number of overlapping conditions in each group.
They also found that each of the three diagnosis types they were looking at was independently associated with fibromyalgia. Thyroid disease and gynecologic surgery were significantly more common in women with fibromyalgia than those with other types of chronic pain.
The timing of the gynecologic surgeries in relation to pain onset was especially interesting. They found more surgeries in the years just before fibromyalgia pain began, or in the year after pain onset. That pattern was unique to the fibromyalgia group.
At first glance, it may seem odd that gynecologic surgeries in the year after pain onset would be considered related to the development of fibromyalgia.
However, an association like that may be due to several pertinent factors.
For example, consider that many women have gynecologic problems well before they opt for surgery as the preferred treatment. It may be that hormonal changes or gynecologic disease are risk factors for fibromyalgia because of some underlying relationship that we don’t yet understand.
According to the study, hysterectomies and oophorectomies (removal of the ovaries) were most likely within the four years before or after the onset of fibromyalgia pain.
This is certainly an area that calls for more research. In the end, it could help us understand why 90 percent of fibromyalgia patients are women. Beyond that, it may reveal physiological changes that can trigger the development of the illness, which could lead to better treatments and possibly even prevention.
For the women who develop fibromyalgia after gynecologic surgery, we also need to know what role, if any, the surgery itself plays, as well as the possible roles of hormonal changes caused by the surgery. Post-surgical hormone replacement therapy deserves a look, too.
Doctors have long suspected that fibromyalgia has strong hormonal ties and triggers. A 2013 study found links between early menopause and increased pain sensitivity in fibromyalgia patients, which may relate to dropping estrogen levels.
Women with fibromyalgia are especially prone to painful menstrual periods (dysmenorrhea) and certain pregnancy complications.
My Experience
This study really speaks to my own experience. I was 34 when my youngest child was born via c-section, and 35 when I stopped breastfeeding. The hormonal changes from that, according to my gynecologist, launched me into premature perimenopause.
My menstrual cycle became erratic and periods were extremely heavy and painful, whereas they’d always been regular and fairly mild. Fibromyagia symptoms soon followed.
Six months later, I had a diagnosis and had identified a pattern—my flares came regularly between ovulation and the start of my period. My gynecologist recommended an endometrial ablation to get rid of hormones put off by the thickening uterus.
I hadn’t had a hysterectomy, but between two pregnancies and two c-sections, plus breastfeeding, my body had clearly been put through a hormonal ringer.
I suspect that research will continue to bear out the links between fibromyalgia and hormonal changes and hope that someday, we’ll be a lot better equipped to recognize, treat, and prevent hormone-related fibromyalgia.
A Canadian researcher thinks he has uncovered one. Ian Gilron is the Director of Clinical Pain Research, Professor of Anesthesiology, and Biomedical Sciences, and Faculty in the Centre for Neuroscience Studies at Queen’s University in Kingston, Ontario, Canada
The results of a trial suggest that combining pregabalin (Lyrica), an anti-seizure drug, with duloxetine (Cymbalta), an antidepressant, can safely improve outcomes in fibromyalgia, including not only pain relief, but also physical function and overall quality of life. Until now, these drugs have been proven, individually, to treat fibromyalgia pain. “Previous evidence supports added benefits with some drug combinations in fibromyalgia,” says, Dr. Gilron. “We are very excited to present the first evidence demonstrating the superiority of a duloxetine-pregabalin combination over either drug alone.”
Fibromyalgia was initially thought to be a musculoskeletal disorder. Research now suggests it’s a disorder of the central nervous system – the brain and spinal cord. Researchers believe that fibromyalgia amplifies painful sensations by affecting the level and activity of brain chemicals responsible for processing pain signals.
“The condition affects about 1.5 to 5 percent of Canadians – more than twice as many women as men. It can have a devastating on the lives of patients and their families,” explains Dr. Gilron. “Current treatments for fibromyalgia are either ineffective or intolerable for many patients.”
This study is the latest in a series of clinical trials – funded by the Canadian Institutes of Health Research (CIHR) – that Dr. Gilron and his colleagues have conducted on combination therapies for chronic pain conditions. By identifying and studying promising drug combinations, their research is showing how physicians can make the best use of current treatments available to patients.
“The value of such combination approaches is they typically involve drugs that have been extensively studied and are well known to healthcare providers,” says Dr. Gilron.
This new research was published in the journal Pain.
Dr. Gilron and his research team at Queen’s are members of the SPOR Network on Chronic Pain. The national network, funded under Canada’s Strategy for Patient-Oriented Research, directs new research, trains researchers and clinicians, increases access to care for chronic pain sufferers and speeds up the translation of the most recent research into practice.
During a pain flare, feeling anything touch your body can be excruciating. On those days, you’ll likely reach for soft, comfortable clothes that don’t add to your pain. Hello leggings, goodbye tailored pants.
While you could just throw on an old T-shirt, wearing something that’s fashionable and comfortable can help boost your mood and make you feel more confident if you have to run out to the pharmacy or go to work. Luckily, there are many brands out there that offer a variety of comfortable and fashionable options.
LuLaRoe bills itself as “where fashion meets comfort,” and indeed, the company offers a selection of loose-fitting tops and T-shirts, stretch-knit dresses, A-line skirts, and leggings (their most popular item). Unlike many clothing collections designed for comfort, these pieces come in a variety of vibrant colors and patterns. A pair of leggings usually retails for $25.
“In the past few weeks, I’ve been buying more and more LuLaRoe clothing,” Samantha Carter told The Mighty. “The leggings provide the support that isn’t constricting when I’m dealing with an interstitial cystitis flare or muscle spasms relating to other pelvic issues, and the tops and dresses are loose and flowy, so they don’t irritate my skin when my nerves start going bonkers from my fibromyalgia and complex regional pain syndrome — even when everything else I wear feels like it’s constantly scratching a sunburn I don’t really have.”
A bad pain day sometimes means all you can tolerate is the basics — T-shirt, underwear, and maybe leggings or sweatpants. Hanes offers wardrobe staples in soft and comfortable cotton and jersey. As an added bonus, many of their shirts are tagless. Most items cost between $3.99 and $20.
Not all women like the idea of wearing maternity clothes when they’re not pregnant (especially those struggling with infertility). But if you’reOK with it, maternity clothes can provide comfort to those dealing with chronic pain, weight fluctuations, skin sensitivity, and bloating. Motherhood Maternity offers tunic tops (retailing for around $30), maxi skirts ($35), and jeans with stretch waistbands ($50).
“Motherhood Maternity Secret Fit Belly Jeans. I started wearing them during pregnancy and still love them because they don’t bother my back, actually the belly band puts slight pressure on my lower back which helps ease some pain,” Kristina Bentle told The Mighty. “Plus I love that they help with my hypersensitivity, they don’t dig into you like normal jeans. And I’m not running around in leggings 24/7.”
For the days when you’re able to put on a pair of shoes, you’ll likely want a brand that offers support but doesn’t constrain any part of your foot. “[Sketchers] is the only brand that doesn’t pinch my Achilles’ tendon or put shock into my kneecaps,” Jaime Robeson told The Mighty. Most pairs retail for around $50 to $70.
And1 is a men’s athletic brand that offers basketball shoes, shorts, sweatpants, and hoodies. Just because it’s a men’s brand doesn’t mean women can’t wear it, too. “I can buy oversized sweatpants, hoodies, shirts. Really cozy and keep me warm when I’m super cold,” Nicole Tyrrell shared. Most items retail for around $10 to $20.
Torrid features funky, trendy styles up to a size 30. Their leggings come in a variety of fun prints, including Disney and Harry Potter, and most of their tops and dresses feature a loose fit. Leggings cost about $25 to $30, dresses go for about $60, and tops are about $28 to $50.
“Yes, I am bigger, but not all Torrid’s line is large. They are edgy which is nice for me, they have leggings like LuLaRoe in funky colors and schemes. Pair the two and I feel comfortable and punk again,” Rebecca Stormcrowe said.
Old Navy combines classic items like T-shirts and jeans with natural fabrics and forgiving cuts. Most items come in a rainbow of colors and low prices (most pieces are less than $50, with some shirts as low as $6). “I shop a lot at Old Navy because so many of their clothes are cotton. Cotton and rayon are my go-to’s.” Amanda Coleman said.
PINK is Victoria’s Secret’s apparel collection and offers sweatshirts, leggings, sweatpants, and shorts with stretchy waistbands, as well as oversized shirts and tanks in feminine prints and colors. Most items sell for between $30 and $60. “I wear a lot of PINK clothing as it can be very loose and soft,” Kerri Donchez told The Mighty.
Chico’s blouses and dresses could easily be worn to work or out running errands on the days you’re able to leave home. Nancy Lea Martine Koontz gave The Mighty a tip and recommended shoppers go up a size since Chico’s sizing system is “weird.”
“The clothing is comfy, and even ordering a size larger still fits well, and isn’t uncomfortable as far as bottoms and tops go. They are a little pricey, however, you can get an app, Poshmark, which is a wonderful site that sells many name brand clothing at a discount (it’s kind of like an online consignment store),” Koontz said.
Yours offers a huge selection of everything from wraps to tunic dresses to knitwear, all in sizes 16 to 36. The styles are ideal for those who prefer looser clothing over more structured pieces. Dresses range from $20 to $100, blouses from $30 to $40, and pants around $30.
“Lots of roomy long T-shirts and batwing tops, jeggings. I don’t feel comfortable in clingy, tight-fitting clothes,” Libby Listens Bassnett told The Mighty.
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.
