09/21/2025
Fibromyalgia frequently happens with TMJ probems.
https://www.healthmarketingai.com/solving-tmj-book
Find out more.
“Extreme Itching in Fibromyalgia and Chronic Fatigue Syndrome”
By Adrienne Dellwo, Updated on May 02, 2024
Medically reviewed by David Ozeri, MD
The itchiness associated with fibromyalgia is known as a neuropathic itch. It is a specific type of itch that stems from an injury to nerves of the central nervous system (involving the brain and spinal cord) and/or the peripheral nervous system (involving nerves outside of the brain and spinal cord). Neuropathic itchiness can sometimes be severe and difficult to treat.
The itch complicates the widespread neuropathic pain associated with fibromyalgia. Scratching the itch only serves to intensify the pain. With the appropriate treatment, including antidepressants like Cymbalta (duloxetine) and antiseizure drugs like Lyrica (pregabalin), both can be relieved.
This article describes what a fibromyalgia itch feels like, the causes, and what you and your healthcare provider can do to treat it.
What Fibromyalgia Itching Feels Like
An itch (also known as pruritus) is a commonplace event that occurs when receptors in the skin (called nociceptors) are stimulated.
Many different factors can stimulate nociceptors depending on whether the cause originates in the skin (dermal itch), is triggered by emotions (psychogenic itch), is due to the dysfunction of the nervous system (neurogenic pain), or results from an injury to nerves (neuropathic itch).
The general medical consensus is that a fibromyalgia itch is neuropathic (although the exact cause of this is only starting to be understood).
With fibromyalgia, the itch manifests in a specific way:
~It is often described as intense, stinging, burning, aching, or sunburn-like.
~It is not relieved by scratching (and scratching can often make it worse).
~The itching may be generalized (widespread) or limited to a specific area of the skin serviced by a spinal nerve root (called a dermatome).
~The itching is sometimes accompanied by sensations of cold or heat.
~The itching may be intermittent (coming and going) or chronic (persistent).
~Excessive sweating (hyperhidrosis) sometimes accompanies acute itching episodes.
Causes of Fibromyalgia Itching
The exact cause of fibromyalgia is unknown but is believed to involve a combination of genetic and environmental factors. However, scientists do have a pretty strong understanding of how neuropathic itches develop.
At its heart, neuropathic itch and neuropathic pain are both manifestations of an abnormal condition of the nervous system known as central sensitization.
Central sensitization is a process in which the central nervous system undergoes changes that alter the way it processes pain and other sensory stimuli. It is believed to be the underlying mechanism that gives rise to fibromyalgia as well as a related condition known as chronic fatigue syndrome (ME/CFS).
Central sensitization is characterized by nerve hypersensitization (an overreaction of nerves to otherwise harmless stimuli). This, in turn, can manifest with hyperpathia (an exaggerated reaction to touch and other stimuli) and allodynia (pain caused by stimuli that usually don't cause pain).
With fibromyalgia itching, a specific type of nociceptor called a "silent nociceptor" is involved. As opposed to mechanosensitive nociceptors that respond to mechanical, thermal, or chemical stimuli, silent nociceptors are only activated during inflammation or tissue injury somewhere in the body.
A 2014 study in the Annals of Neurology found that while mechanosensitive nociceptors in people with fibromyalgia behaved normally, silent nociceptors were "hyperexcitable" in more than three out of four people with fibromyalgia
It is unclear what activates these "silent" receptors, but experts suspect that it may be the same things thought to trigger fibromyalgia pain. Theories include:
~The dysregulation of neurotransmitters (chemical messengers in the brain)
~The dysfunction of the body’s stress response system called the HPA axis
~An inflammatory reaction in the central nervous system
~The dysfunction in the autonomic nervous system which regulates the “fight or flight” response
When to See a Healthcare Provider
Recent studies have found a link between a delayed diagnosis of fibromyalgia and a reduced response to fibromyalgia treatments. What this means is that if you think you have the symptoms of fibromyalgia, it is in your interest to see a healthcare provider sooner rather than later when the condition may be more treatable.
Although the itching is usually accompanied by tenderness and pain, you should be aware of other symptoms commonly seen in people with fibromyalgia, including:
~Pain and stiffness all over the body
Persistent fatigue and tiredness
~Depression and anxiety
~Sleep problems
~Problems with thinking, memory, and concentration
~Headaches, including migraines
~Tingling or numbness in hands and feet
~Pain in the face or jaw
~Digestive problems, such as abdominal pain, bloating, and constipation
Treatment for Fibromyalgia Itching
There are at-home remedies and medical treatments that may help ease fibromyalgia itching. There is no cure for fibromyalgia, so treatments are focused on relieving symptoms.
Home Remedies
Fibromyalgia itching can be challenging because scratching can make it worse. So rather than scratching, try reducing the itch by:
~Applying a cold compress or cool cloth to the skin for 10 to 15 minutes several times a day
~Keeping moisturizer in the refrigerator and applying it to the skin whenever needed
~Moisuring throughout the day to avoid dryness that can aggravate itching
~Using an over-the-counter (OTC) numbing cream like Caladryl
~Getting an OTC anti-itch cream containing 1% hydrocortisone
~Taking an OTC painkiller like Tylenol (acetaminophen) or Advil (ibuprofen)
~Avoiding perfumed lotions or cleansers that can irritate the skin
~Trimming your nails and wearing gloves at night to prevent scratching
~Keeping the temperatures cooler inside with air conditioning
One of the best ways to cope with fibromyalgia symptoms is to regularly engage in low-intensity exercises. Physical activity can help elevate moods, relieve stress that contributes to symptoms, and release chemicals called endorphins that help "mute" pain signals.
Examples of low-intensity exercises include:
Stretching
Water aerobics
Yoga
Tai chi
Dancing
Swimming
Cycling
Sleep is also essential as a lack of sleep can worsen fibromyalgia symptoms. If you have trouble sleeping, improve sleep hygiene by going to bed at the same time every night, keeping the bedroom dark and cool, and avoiding video games, electronics, and other things that can overstimulate you before bedtime.
Medications
There are three drugs currently approved by the Food and Drug Administration (FDA) for the treatment of fibromyalgia:
•Savella (milnacipran): A type of antidepressant called an SNRI that increases neurotransmitters in the spinal cord that reduce pain signals
•Cymbalta (duloxetine): Another SNRI with similar action to Savella but one that may also help elevate moods more actively
•Lyrica (pregabalin): An anti-epilepsy drug that interferes with the transmission of pain signals to the brain.
Other prescription drugs may be used in the treatment of fibromyalgia, including:
•Ultram (tramadol): An opioid painkiller that may be used in severe cases for short-term relief
•Muscle relaxants: These include Flexeril (cyclobenzaprine) and Zanaflex (tizanidine) and Baclofen
•Neurontin (gabapentin): Another anti-epilepsy drug commonly used for nerve pain
•SSRI antidepressants: Another class of antidepressant that includes Celexa (citalopram) and Lexapro (escitalopram)
•Tricyclic antidepressants: An older type of antidepressant that includes Elavil (amitriptyline)
Cognitive Behavior Therapy (CBT)
In addition to medications, a form of talk therapy called cognitive behavioral therapy (CBT) is frequently used to support fibromyalgia treatment. CBT helps people identify and avoid behaviors that can aggravate fibromyalgia symptoms (such as "catastrophizing" pain rather than accepting pain and learning to live with it).
Summary
Itching is common with fibromyalgia and is caused by the hypersensitivity of nerve receptors in the skin called nociceptors. The itch is the consequence of a process called central sensitization in which the central nervous system abnormally processes and amplifies sensory nerve signals. Fibromyalgia itching can be intense and get worse with scratching.
Topical treatments and oral painkillers may help relieve a fibromyalgia itch. Antidepressants, anti-epilepsy drugs, and cognitive behavioral therapy (CBT) can also be very effective.
Source: https://www.verywellhealth.com/extreme-itch-in-fibromyalgia-chronic-fatigue-syndrome-3972965
