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TYPES OF FIBROMYALGIA (FM) PAIN
You hear a lot about "fibromyalgia pain," but really those of us with fibromyalgia (FM)
experience several kinds of chronic pain.
Medically speaking, only a few of the fibromyalgia pain types have
actual names and definitions. But just as Eskimos have several words for snow, I feel like
we need to have several ways to name, define and categorize our pain. Here are some of
my own categories, based on my own experiences. Knowing the medical terms will help you
communicate better with doctors and other healthcare providers, while my categories will
help you understand your illness and let you know you're not alone.
Types of Fibromyalgia Pain
The first 3 types of fibromyalgia pain are medically defined:
The next 4 types are obvious by their names. I wouldn't yse these terms in a doctor's
office, they might think you're crazy, but these names may help you get to know your
body's patterns, etc.:
- Knife in the Voodoo Doll
- Randomly Roving Pain
- Sparkler Burns
- Rattled Nerves
Paresthesia & Fibromyalgia
Paresthesias are odd nerve sensations that can feel like crawling, tingling, burning,
itching or numbness. Sometimes, these sensations can be painful. Paresthsias are also
associated with peripheral neuropathy, chemotherapy drugs, multiple sclerosis and migraine.
Many common FM treatments can help alleviate paresthesia-related pain, including selective
serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors
(SNRIs). Some people also have good luck with vitamin B12, capsaicin cream, massage and
acupuncture.
Hyperalgesia & Fibromyalgia
"Hyper" means excess and "algesia" means pain. Hyperalgesia is the medical term for pain
amplification in FM. Our brains appear to take normal pain signals and "turn up the
volume," making them more severe than they would normally be.
Most of the drugs used for managing FM pain are aimed, at least in part, at reducing
hyperalgesia.
Allodynia & Fibromyalgia
A symptom that perplexes a lot of us, especially when it's new, is allodynia. That's what
it's called when your skin hurts to the touch, and when mild pressure from clothing or
gentle massage causes pain. A lot people describe allodynia as similar to a bad sunburn.
Allodynia is a fairly rare type of pain -- other than FM, it's only associated with a
handful of conditions, including neuropathy, postherpetic neuralgia (shingles) and
migraine. Allodynia is believed to be a hypersensitive reaction that may result from the
central sensitization associated with FM. The pain signals originate with specialized
nerves, called nociceptors, that sense information about things like temperature and
painful stimuli right from the skin.
Allodynia comes in 3 forms:
- Tactile, which is pain from touch or gentle pressure
- Mechanical, which is from something moving across your skin
- Thermal, which is pain from heat or cold that's not severe enough to damage tissues
Some drugs that work for some people with allodynia include:
Some people also get relief from topical pain creams (capsaicin, Tiger Balm,
Aspercreme, BioFreeze). Paying close attention to the way you dress can help alleviate
allodynia as well.
If you have allodynia, massage therapy may make it worse. If you feel other aspects of
your health would benefit from massage, be sure to discuss allodynia with your doctor and
massage therapist and keep track of how treatments impact this symptom.
My Own Fibromyalgia Pain Categories
Once again, the following categories are not medically recognized - they're things I came
up with to fill a gap in how we classify different types of pain. They're intended to help
you track symptoms, gauge effectiveness of treatments, and to let you know you're not
alone.
Knife in the Voodoo Doll
Sometimes, out of nowhere, I'll get an intense stabbing pain that seems to cut through my
body. I generally get this pain in my chest or abdomen, but some people say they get it in
other parts of the body. It can be so intense that it makes it hurt to breathe. It usually
goes away as fast as it comes. I have no idea how to prevent this type of pain, other
than by pacing myself.
Randomly Roving Pain
This is one of those things that reminds you FM just doesn't make a lot of sense. A lot of
us get pain that migrates around the body, sometimes moving between certain places,
sometimes striking in new areas. If you also have myofascial pain syndrome, it can be
especially hard to tell randomly roving pain from the referred pain caused by trigger
points. For me, this pain responds to treatments about the same as hyperalgesia.
Sparkler Burns
Remember when you were a kid and you hung onto a sparkler for too long? The sparks hit
my hand causingtiny pin-pricks of pain? I have almost the same sensations today.
They make me jump, and scratching them triggers tactile allodynia. These
sensations usually just last a few seconds. I have no idea what triggers them or how to
prevent them.
Rattled Nerves
Most people won't understand why I call this a type of pain, but I'm sure most people with FM will get it. Certain things tend to get my whole body on edge, jumpy, and feeling
rattled. It makes me ache all over, and sometimes I get nauseous, dizzy and anxious.
Things that rattle my nerves generally involve sensory or emotional overload, such as:
- Certain sounds (repetitive, loud, shrill, grating, screaming kids)
- Visual chaos (crowds, flashing lights, busy patterns)
- Stressful situations (busy traffic, confrontations, fibro-fog induced confusion or
disorientation)
When my nerves are rattled, I try to get out of the situation as quickly as possible and
relax, preferably somewhere quiet.
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