Fibromyalgia Back Pain: Causes, Symptoms, & Relief Strategies

Dealing with back pain that doesn’t seem to ease up? Fibromyalgia may be intensifying your discomfort.

This article explores back pain related to fibromyalgia and how it differs from other types of pain, plus proven strategies to manage and treat your pain.

Cause of fibromyalgia-induced back pain

Unlike typical back pain, which may stem from obvious physical issues such as injury or strain, you might have fibromyalgia-related back pain without any physical damage. This type of back pain is caused by a complex interplay of factors in the body's pain system that lead to a heightened sensitivity to pain.

This is called central sensitization, which is when the body's central nervous system (sometimes in collaboration with the immune system) has become overactive in pain processing. The resulting pain is called nociplastic pain. This means that your back pain is genuine, but instead of being caused by structural damage, an overprotective system is leading to heightened back pain sensitivity.

So, what causes central sensitization? Ongoing genetic research has identified several genes that may influence pain sensitivity, which indicates that some people have a hereditary influence on fibromyalgia and back pain. This means that fibromyalgia can run in families and your DNA can predispose you (that is, increase your risk) to developing the condition, which in turn may lead to back pain.

Another risk factor is experiencing difficult physical or emotional events. Events such as trauma, stress, illness, or injury can cause changes in various body systems, including the nervous, hormonal, and immune systems. These changes can lead to a sensitized central nervous system, potentially leading to fibromyalgia symptoms and chronic back pain.

Fibromyalgia back pain symptoms

The experience of back discomfort from fibromyalgia can vary widely among individuals. Some might liken it to a relentless ache that pervades their entire back, while others report localized spots of intense discomfort that flare up, especially under stress.

Key symptoms of fibromyalgia-related back pain include the following:

• Widespread back pain – unlike isolated back issues, fibromyalgia can cause pain that feels as though it encompasses every inch of your back, with a particular propensity for aching, stiffness, and muscle fatigue.
• Exhaustion – the fatigue that accompanies fibromyalgia goes beyond mere tiredness to an overwhelming sense of exhaustion that can compound the distress of chronic back pain.
• Emotional and mood variations – psychological distress such as depression and anxiety frequently coexists with fibromyalgia and can magnify the severity of back pain.
• Tender points along the back – the back is a common area for tender points, which are specific spots that are extremely sensitive to touch and can cause deep, persistent pain upon pressure.
• Increased back sensitivity – a heightened sensitivity in the back to touch, temperature changes, and pressure can lead to a more pronounced experience of pain.
• Morning stiffness – a common complaint among those with fibromyalgia is a pronounced stiffness in the back upon waking or after prolonged periods of inactivity, which can significantly impact daily activities.

Common fibromyalgia back pain spots

Back pain from fibromyalgia often appears in targeted areas, but can be felt anywhere along the spine. Here are a few common places where back pain from fibromyalgia is felt.

• Between the shoulder blades – fibromyalgia back pain between the shoulder blades is common because of the numerous muscles and tendons in this area. These tissues can become sensitive, leading to pain that feels almost as if it radiates from the inside out.
• Upper back – fibromyalgia pain in the upper back can often be felt along the trapezius muscle, which spans from the neck to the mid-back, and is often associated with tension and stiffness.
• Lower back – fibromyalgia lower back pain symptoms often show up as a persistent deep aching or throbbing sensation. This pain can radiate, spreading to the buttocks and legs, and may be accompanied by a sensation of stiffness or burning.

How to tell if your back pain is fibromyalgia

Fibromyalgia back pain is often discernible from other types of back pain by its characteristic widespread nature, deep, aching sensation, and persistent stiffness. This pain typically encompasses the entire back and is accompanied by symptoms such as pronounced stiffness and tenderness at specific points, often described as tender points.

Unlike pain stemming from injuries or inflammation, fibromyalgia pain is not externally visible and tends to be exacerbated by factors like stress, physical activity, and weather changes.

How does fibromyalgia back pain compare to other conditions?

Muscle or ligament strain – muscle strains can occur from sudden movements or overuse, especially if you do movement that you're not used to! This type of back pain is characterized by a sharp or sudden pain that is localized to the area of the strain. Unlike the widespread pain of fibromyalgia, the discomfort from a strain is typically confined to the injured muscle or ligament and will get better within a few weeks.

Axial spondyloarthritis – axial spondyloarthritis (AxSpA) refers to types of inflammatory arthritis in the spine and sacroiliac joints – the joints that link the spine to the pelvis. This inflammation is caused by the body's immune response. Although fibromyalgia can cause low-grade inflammation, fibromyalgia back pain is primarily due to an overactive nervous system. This shows up as widespread pain without the typical signs of inflammation, which include redness, warmth, and swelling.

Scoliosis – scoliosis, in which the spine curves to the side, typically begins in childhood although it may not cause pain until later in life. The structural changes in the spine can be clearly seen on scans and it's these differences that lead to uneven pressure on the joints and muscles and result in localized back pain. Fibromyalgia pain, on the other hand, is widespread and is not caused by structural abnormalities.

Bulging discs – bulging or ruptured spinal discs can be seen on scans and can press on nerves, causing localized pain, numbness, or weakness along the affected nerve. This pain is specific to the path of the nerve and differs from fibromyalgia, which does not involve nerve compression.

Osteoporosis – compression fractures, which can usually be seen on X-rays, from osteoporosis can lead to sharp, localized back pain from the affected vertebrae. In comparison, fibromyalgia pain is more diffuse and not related to bone density.

Sciatica – sciatica is irritation or compression of the sciatic nerve and leads to pain that radiates from the lower back down through the leg. This condition is characterized by a sharp or shooting pain, whereas dull and aching sensations are more typical of fibromyalgia.

Autoimmune conditions – conditions such as rheumatoid arthritis can cause inflammatory back pain due to joint and tissue inflammation. This pain is often concentrated in affected joints, contrasting with the diffuse, aching pain of fibromyalgia that is not caused by joint inflammation.

Strategies for relieving fibromyalgia back pain

Finding a treatment for fibromyalgia back pain can be a bit of trial and error but is well worth the time. Finding the right treatment, or combination of treatments, can significantly improve your quality of life, even if it doesn't completely cure your pain.

A multidisciplinary approach to retrain your pain response is the gold standard in chronic pain care. It’s usually the most effective method for long-term relief because it addresses the underlying cause, rather than just treating symptoms. It goes hand-in-hand with lifestyle changes for managing fibromyalgia back pain, which include reducing stress, regular physical activity and improving your sleep habits.

Retraining your pain response

The multidisciplinary approach of MoreGoodDays® focuses on teaching you to retrain your pain response, which in turn can decrease the intensity and frequency of your pain and other symptoms.

It’s grounded in the biopsychosocial model of pain, which acknowledges that pain is not just a physical sensation but is also influenced by psychological or emotional factors, as well as social ones. This comprehensive strategy involves learning about the nature of pain and how various factors, including stress, beliefs, and behaviors, can modify your perception of pain.

In practice, this means learning to identify your specific pain triggers, and then learning techniques – based on the principles of neuroplasticity – to rewire your brain's response to these triggers. These tools and strategies include:

• cognitive behavioral therapy and somatic tracking to alter pain-related thoughts
• stress management to reduce overall body tension and reset chronic stress-induced imbalances in hormone and neurotransmitter levels
• mindfulness to reduce stress and emotional distress
• pacing to prevent overexertion
• movement and exercise (it doesn't have to be formal exercise! Walking, swimming, and simple strength exercises at home can do wonders) to improve and maintain muscle strength and mobility
• gentle stretching, such as yoga and Pilates, to loosen up stiff joints and muscles when you’re feeling sore
• using food as medicine through nutritional guidance aimed at best supporting your body's optimal state
• boosting your sleep to reduce pain and fatigue, plus boost mood.

Our program offers dedicated support to help you reduce the severity of pain, reduce the frequency of flare-ups and reduce the emotional distress that chronic conditions like fibromyalgia can cause.

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Short-term pain relief

Although retraining your pain response is the long-term goal, you probably want some short-term and flare-up relief too.

Medications, when used as directed and in consultation with your healthcare provider, can play a supportive role in your recovery journey. It's essential to have a conversation with your doctor and pharmacist about them.

We believe that medications are best used as enablers of therapeutic activities, rather than mere pain relievers. This is because medications might only be effective in the short-term, but they make it much easier for you to engage with other the treatments and therapies – such as movement or psychology – that make long-term differences by gradually reconditioning your body and pain response over time.

The best type of medications for fibromyalgia are often simple over-the-counter pain relief, such as paracetamol. However, your healthcare provider might also suggest pain and inflammation modulators, or antidepressants. If they do, it doesn't mean that you are depressed! Antidepressants for chronic pain can help reduce pain and improve sleep.

Other forms of short-term pain relief include using heat packs or cool packs (or warm or cool baths or showers), depending on what works best for you. These simple, non-invasive methods can ease pain, help relax tense muscles and reduce stiffness.

Wrap hot or ice packs in a thin towel to avoid direct skin contact and prevent skin discomfort. Typically, using the pack for 15 to 20 minutes and then taking a break can offer respite from the pain and is a comforting way to soothe the body.

Many alternative treatments can also be useful pain relievers. However, similar to medications, these passive therapies often only give short-term benefits, so it's best to use these in combination with other therapies such as exercise. Some of the typical options that help fibro back pain include:

• massage – massage therapy can help give short-term relief from pain and muscle stiffness through relaxation techniques and joint and muscle manipulation.
• acupuncture – acupuncture can reduce your discomfort and enhance your sleep quality, improving your overall wellbeing.‍
• chiropractic – regular chiropractic treatments can help manage pain and improve other symptoms of fibromyalgia, such as fatigue.

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