Understanding Fibromyalgia in Hands: Symptoms & Relief Strategies

Fibromyalgia is primarily a disorder of the central nervous system that may also involve the immune system.

It causes altered pain processing through what is known as central sensitization. This is when the body’s nervous system has become overwhelmed and overprotective, and the result is widespread chronic pain and other symptoms, such as fatigue and brain fog, in the absence of physical damage. This includes symptoms in the hands, including aching, stiffness, or tingling.

The most effective way to treat hand symptoms caused by fibro involves a combination of approaches. This includes learning about the underlying cause of pain, carrying out gentle exercises and soothing treatments such as heat therapy, alongside professional treatments such as occupational and physical therapy.

Signs & symptoms of fibromyalgia hand pain

What does fibromyalgia feel like in your hands?

If you have fibromyalgia affecting your hands, you might experience stiffness, aching, and tingling sensations.

Stiffness in the hands can make your hands feel rigid and inflexible, almost as if they are encased in invisible, tight gloves. This can reduce your hand function and grip strength, making simple tasks such as brushing your teeth, getting dressed, or driving quite challenging. For most people with fibro, joint and muscle stiffness is worse first thing in the morning and improves as the day goes on. However, it also tends to recur after periods of rest.

In addition to stiffness, you might have a persistent, dull ache in your hands that feels relentless, and many people also feel a tingling or buzzing sensation. This might be akin to the prickly feeling when a limb “falls asleep”. This sensation often encompasses the whole hand, and can even extend up the arm. Unlike temporary numbness, this sensation is a continuous presence that can profoundly affect hand functionality.

The severity of these symptoms can vary, often intensifying due to factors like stress or colder temperatures.

Fibromyalgia, and being in constant discomfort, can also lead to other symptoms. For example, fatigue, cognitive challenges – such as struggling to think clearly or remember things – trouble sleeping, feelings of anxiety or depression, and a heightened sensitivity to sensory information – such as bright lights and loud noises. These are common symptoms for many people with fibromyalgia.

Other conditions that cause hand pain

There are a number of other conditions that can cause pain and stiffness in the hands.

Fibromyalgia and carpal tunnel syndrome are both known to cause hand pain, as can arthritis and gout. But these conditions present in different ways.

Fibromyalgia in hands & carpal tunnel syndrome

Carpal tunnel syndrome typically causes localized pain, especially in the fingers or hand. This pain, often accompanied by numbness, tingling, and weakness, is due to pressure on the median nerve in the wrist. In contrast, there is no nerve pressure in fibromyalgia, and you’re likely to experience widespread pain that affects both hands, as well as other areas of the body.

However, it is possible to have both conditions, and research indicates that if you have fibromyalgia, you are also more likely to develop carpal tunnel syndrome. Fibromyalgia does not increase your risk of developing pressure on your median nerve. However, because having fibro has intensified your body’s pain response, it can make the symptoms of carpal tunnel syndrome more pronounced.

In contrast to fibro, which cannot be tested for and which doesn’t require surgery, carpal tunnel syndrome can be tested for through nerve conduction studies and sometimes imaging tests, and may require surgical intervention in severe cases.

Arthritis, gout, or fibromyalgia in the hand?

Hand pain can also emerge from other health conditions, such as arthritis, and gout. While these conditions may exhibit similar symptoms as fibromyalgia, such as stiffness and discomfort in the hands, they each possess unique characteristics.^[5]

Arthritis mainly impacts the joints and causes inflammation, swelling, and stiffness, in addition to localized pain. This swelling at the joints – usually in the fingers and knuckles – can cause joint damage, deformities, and loss of hand function over time.

Gout is a specific type of arthritis that results from an excess of uric acid (a normal waste product of our metabolism) in the body. This condition can cause sudden, intense pain, redness, and swelling in the hands due to the formation of urate crystals in the joints. While gout doesn’t typically cause long-term joint damage, without effective management, it can lead to recurrent painful attacks.

Fibromyalgia on the other hand (if you’ll excuse the pun!), does not cause swelling or deformity of the joints in the hands. In fact, fibromyalgia is characterized by widespread musculoskeletal pain, fatigue, and localized tenderness without any physical damage.

Fibromyalgia hand pain relief & treatment options

For effective relief of fibromyalgia hand pain, a comprehensive approach is recommended.

The gold standard is a multidisciplinary approach that includes understanding pain, and your unique set of circumstances and how they impact your symptoms. Armed with this knowledge, you can then learn different tools to tackle your triggers, and these can include:

• specific hand exercises to reduce stiffness and increase your hand strength and function
• practicing gentle whole body movement to retrain your pain system
• immediate pain relief strategies such as heat therapy
• addressing stress in your life, for example through psychology or meditation
• improving your sleep
• eating a healthy, anti-inflammatory diet and looking after your gut health.
• identifying and managing your other unique symptom triggers.

You may also include medical interventions and alternative therapies, all of which can be tailored to suit your individual needs.

Diet & lifestyle in managing hand pain

While there's no one-size-fits-all diet for chronic pain, including fibromyalgia hand pain, certain dietary choices can make a significant difference.

Consuming anti-inflammatory foods can support your overall health and help reduce the low-grade inflammation that is a common factor in fibromyalgia pain. These foods include:

• colorful fruits and vegetables
• lean proteins
• healthy fats
• whole grains.

On the other hand, certain foods may exacerbate symptoms. Pro-inflammatory items such as red and processed meats, refined grains, sugary treats, sweetened beverages, and fried foods may increase inflammation and worsen hand pain. Avoiding these foods can help in reducing the body's inflammatory response and alleviate fibromyalgia symptoms.

Your gut health also plays a crucial role in both your physical and mental wellbeing.

You can support your gut health by eating probiotics, which are found in foods such as yogurt with active cultures, sauerkraut, and kefir, and prebiotics, which are found in foods like garlic, onions, and bananas. Although if you have digestive issues, such as irritable bowel syndrome, be slow and steady when making any changes to your diet and consider talking with a registered dietitian. 

Staying hydrated is also key to managing symptoms effectively and keeping your gut happy, so always drink plenty of water and unsweetened drinks.

Medical

In managing fibromyalgia-related hand pain, medication is part of a broader pain-management plan, but not the sole treatment. Medications can help you to overcome barriers such as acute pain, mood challenges, or fatigue, so that you can engage in other pain-management strategies. These strategies include educational insights, lifestyle adjustments, and psychological support. 

Common medications for fibromyalgia may include:

• antidepressants such as amitriptyline and duloxetine, which can help in pain management (and don’t mean that you are depressed or that it’s all in your head!)[6]
• pain and inflammation modulators such as low dose naltrexone (LDN), which targets specific pain pathways
• over-the-counter pain relievers such as aspirin and ibuprofen
• anti-seizure medications such as pregabalin and gabapentin to mitigate the nervous system's oversensitivity.

Although opioids were previously used for chronic pain, they are not recommended for fibromyalgia because they come with a lot of side effects and risks. They also tend to lose their efficacy over time, so people end up needing to take more in order to get the same level of pain relief.

Alternative therapies

Acupuncture, myofascial release massage, and other alternative therapies might also offer you some relief from fibromyalgia hand pain. 

Research has shown that acupuncture can help alleviate pain, improve sleep quality, and enhance overall wellbeing in some people who live with fibromyalgia.[7] While, others find that myofascial release massage therapy can decrease the sensitivity of their tender points, although there may be potential side effects such as headaches.

We’re all different, and what works for one person, won’t necessarily work for another. In all cases, it’s very important to talk with your regular doctor, pharmacist, and other healthcare providers about any medications or treatments to make sure that they are right for you.

Frequently asked questions

What is the life expectancy of a person with fibromyalgia?

Fibromyalgia does not reduce someone’s life expectancy because it does not impact vital organs, cause physical damage, or pose a serious threat to health, even though it can pose big challenges. People with fibromyalgia can expect a normal life expectancy, and with proper symptom-management, can have a high quality of life.

How is fibromyalgia hand pain diagnosed?

Diagnosing hand pain in fibromyalgia first involves eliminating other causes of pain (such as carpal tunnel syndrome, arthritis and gout). Then, a doctor will confirm that the person has been experiencing widespread chronic pain for at least three months, along with accompanying symptoms such as fatigue, digestive issues, and cognitive difficulties.

The diagnosing doctor might use the fibromyalgia widespread pain index (WPI) score and symptom severity score (SSS), and will probably ask for a medical and symptom history. They may also conduct tests, such as blood and urine tests, to rule out other conditions.

What are some effective self-care techniques for managing fibromyalgia hand pain?

Effective methods for managing hand pain caused by fibromyalgia include gentle exercises, massage therapy, and heat therapy. Incorporating these self-care techniques into your regular routine can provide ongoing relief from the discomfort and other symptoms of fibromyalgia hand pain.

Is heat good for fibromyalgia hand pain?

Heat can be very useful for relieving fibromyalgia hand pain.

Heat therapy works by increasing blood flow to the affected areas, which helps relax stiff joints, reduce muscle tension and offers significant relief from discomfort in the hands caused by fibromyalgia.

There are various ways to apply heat for managing hand pain associated with fibromyalgia, including hydrotherapy (immersing your hands in warm water) and putting heat packs on the hands.