You expect to have painful muscles everywhere with FM. Even if your pain levels vary from day to day, pain is always present.
This pain is intensified, as though the volume control knob is turned up as high as it can go. But there is much more to FM than just the pain. Chances are, you have other sensory-related symptoms that are roaring off the charts and making your FM all the more difficult to manage.
Most patients with FM will recognize the following sensory-related symptoms below:
- cold/heat sensitivity
- numbness and tingling sensations in your extremities
- swelling sensations—feeling as though one’s limbs are made out of gelatin
- burning skin—just like a bad sunburn, despite no redness or visible rash
- sensitivity to loud sounds (you are always asking family members to turn down the volume)
- odours bother you much more than they do everyone else (your sense of smell is heightened)
- light sensitivity – bright lights bother you, maybe even contributing to your headache, especially if you are walking in a colourfully lit shopping mall
- dry, burning eyes—sometimes they hurt so badly, they burn, but your doctor can’t find anything wrong with them and has ruled out medication side effects
- colour blindness
- sensitivity to tastes
Research has indicated that FM sufferers have an increased sensitivity to painful stimulation (Scudds et al. 1987) – Really? In 1993, it was formally hypothesised that FM involves a generalised pattern of hypervigilance, marked by increased attention to a variety of external and internal sensations (Rollman and Lautenbacher 1993)
With hypervigilance, not only do we notice things more readily, we are likely to be unable to divert our attention from them. These diversions – things that are in everyone else’s background but, for some reason, seep into our foreground – are perceived as a threat by our fixated brains, and our physiological response is far more extreme than it should be.
A study by Michael Geisser, Ph.D., also at the University of Michigan, shows that the pain levels of FM are directly tied to these other annoying sensory symptoms. Patients with a greater number and severity of sensory symptoms (such as those highlighted above) tended to predict higher pain scores, a greater number of physical symptoms, and reduced functional capacity. In other words, the more your sensory symptoms become amplified, the worse your FM will become.
Treatments geared at dampening the sensory amplification process may be more effective than tending to each annoying symptom individually, says Geisser. He suggests using medications that operate systemically to tame the signals in the nervous system, rather than to use local or topical approaches to relieve the symptoms.
“Certain agents that may activate the spinal cord’s pain inhibitory system, such as Cymbalta and Savella, may also normalize sensations in other sensory pathways,” says Geisser. “For example, studies have shown that these drugs also decrease the number of subjective symptom complaints in chronic pain patients.”
Medications that work to help filter out the number of sensory signals being amplified in the nervous system may also be beneficial. Examples include Lyrica and Neurontin, which are similar drugs in the anticonvulsant class. If you have already tried these two meds to treat your FM pain but they caused too many side effects, one might still work to ease your amplified senses using a different approach.
Consider talking to your doctor about taking a smaller dose that is less likely to cause side effects and only take it at bedtime. Either drug should aid with sleep, while potentially toning down those annoying sensory symptoms.