Fibromyalgia Knee Pain: Understanding the Connection & Finding Relief

Many people with fibromyalgia frequently deal with knee pain. Why? Central sensitization makes your knees, along with the rest of your body, vulnerable to the chronic widespread pain associated with fibromyalgia.

This piece provides the insights you're seeking, exploring potential causes of your knee pain, distinguishing it from similar knee conditions, and outlining the most effective pain-management strategies.

Fibromyalgia & knee pain connection

Fibromyalgia is known for persistent, all-encompassing pain and often exists alongside other conditions such as osteoarthritis.

The connection between fibromyalgia and knee pain can be attributed to central sensitization, which amplifies pain perception and increases our sensitivity to stimuli, often producing pain even when there is no physical danger to our bodies.

Central sensitization

Central sensitization is like your brain's pain system getting too protective. It takes the normal signals – such as touch, movement, pressure and temperature – and turns them way up, so you feel more pain than you normally would, or even feel pain in situations that wouldn’t normally be painful at all. It's like when you turn up the volume on your music so loud that even quiet songs sound deafening. Except, in this case, it's your knee pain that's getting amplified¹.

For folks with fibromyalgia, this means their knees might ache, throb, or sting because their brain is interpreting normal signals as if they're a much bigger deal than they actually are.

It's a condition where a gentle poke might feel like a harsh jab. That's why something that shouldn't hurt too much can feel super painful if you have fibromyalgia – it's all because your body's pain volume is stuck on high.

What does fibromyalgia knee pain feel like?

When you've got fibromyalgia, knee pain can be a real wildcard. For some, it's like a constant, deep ache that feels like it's coming from the middle of the joint. For others, it's a sharp, jolting pain that can really catch you off guard. And no matter what, there's this annoying stiffness that makes everyday things – such as taking a stroll or climbing stairs – feel like a challenge.

The experience of fibromyalgia-related knee pain is highly unpredictable. Some days you might feel like you can handle it, but then there are days when it's just overwhelming. It's not just the pain that gets to you; it's how it can creep into every part of your life, affecting everything from your exercise routine to how well you sleep at night.

People with this kind of knee pain often say their knees feel puffed up or sensitive to the touch, and this can get worse with weather changes or when they're feeling stressed.

It's different from the normal aches everyone gets now and then because this pain is chronic – it might always be there, lurking in the background, and you have to keep on top of managing it day in and day out².

Overlapping fibromyalgia symptoms & other conditions

The manifestation of knee pain in some people with fibromyalgia can resemble the symptoms of various other knee ailments, which can make the diagnosis and treatment process quite challenging.

Fibromyalgia itself is a syndrome marked by widespread musculoskeletal pain, alongside symptoms of fatigue, sleep disturbances, memory issues, and mood swings.

Unlike the localized pain found in specific joint conditions, fibromyalgia-related pain is more diffuse and common symptoms can impact various parts of the body, including the knees.

Outlined below are the ways in which knee pain from fibromyalgia may resemble symptoms of other conditions.

Osteoarthritis (OA)

• Similarities: Knee pain is a common complaint in both conditions.
• Differences: The pain in osteoarthritis is confined to the affected joint and tends to increase with physical activity. The discomfort arises from the deterioration of knee joint cartilage. In contrast, fibromyalgia pain is more diffuse, affecting multiple areas of the body and can be exacerbated by non-physical factors like stress or changes in the weather. Fibromyalgia knee pain stems from abnormal pain processing in the brain³.

Rheumatoid arthritis (RA)

• Similarities: Both rheumatoid arthritis and fibromyalgia share the characteristic of causing significant discomfort in the joints, including the knees, and can lead to a sense of fatigue.
• Differences: Rheumatoid arthritis is characterized as an autoimmune condition that results in joint inflammation, causing pain and potentially leading to joint deformation. Fibromyalgia, on the other hand, does not induce inflammation or joint damage but instead affects how stimuli are interpreted by the brain.

Patellofemoral pain syndrome (PFPS)

• Similarities: PFPS, which is often referred to as "runner's knee," results in discomfort around the knee's anterior region, a symptom that can be familiar to those with fibromyalgia.
• Differences: PFPS typically arises from activities that involve high knee usage or from kneecap misalignment, whereas fibromyalgia-related knee pain is not directly tied to physical activities and tends to be more chronic and widespread.

Tendonitis

• Similarities: Just like when you overdo it at the gym and your muscles ache, both tendonitis and fibromyalgia can make your knees hurt. It's easy to get them mixed up because the pain feels pretty similar.
• ‍Differences: Tendonitis is like that soreness you get after a workout or if you twist something the wrong way. It usually gets better with rest. Fibromyalgia, though, is like a pain that just doesn’t want to quit. It spreads out and sticks around, and taking a break doesn't really help get rid of it.

Flare-up triggers

Knee discomfort associated with fibromyalgia can be aggravated by several risk factors, including both physical and emotional stress, and even alterations in the weather.

The role of emotional stress cannot be overstated. When we have a fleeting moment of adrenaline – for example when we are crossing a road and suddenly notice something coming  –  but quickly return to a normal and calm state it’s not a big problem. But for many of us our stressors are not simply fleeting moments of worry or melancholy; they’re comparable to carrying an unseen, oppressive load, with each stressor adding to its weight. This significant emotional strain can magnify knee pain, highlighting the necessity for effective stress management techniques for those with fibromyalgia.

Moreover, some people with fibromyalgia have this uncanny ability to predict the weather with their knee pain. It's as if their joints are tuned in to the atmospheric channel, sensing shifts in the environment before the weather forecaster can give us their prediction. The exact reasons for this sensitivity are a bit of a mystery, but it’s likely that with central sensitization, the body can react strongly to environmental changes, such as normal changes in air pressure².

Understanding and identifying your unique triggers is essential for managing your fibromyalgia and alleviating your knee pain. By recognizing patterns and preparing for potential flare-ups, you can turn overwhelming episodes into manageable inconveniences.

Diagnosing fibromyalgia

To diagnose fibromyalgia, your doctor has to act like a detective, piecing together all the different things you've been feeling – the aches all over, the exhaustion, having tummy troubles (think along the lines of irritable bowel syndrome), feeling down or anxious, and having a hard time focusing or remembering things – this last one is often called “brain fog”.

And it's not straightforward because they have to rule out a whole bunch of other health issues first. They call this a diagnosis of elimination.

So to figure out if it's fibromyalgia causing that knee pain, your doctor needs to rule out other possible reasons for your symptoms – such as an injury, OA, or RA – by looking at your medical history and running tests and scans. Only after other conditions are out of the picture, can they confirm that it's fibromyalgia that's been turning your life upside down.

Fibromyalgia knee pain treatment

A comprehensive and multidisciplinary approach to managing chronic pain includes a blend of physical activity, rehabilitation, psychological counseling, and maybe medications. This holistic strategy doesn't just lessen the discomfort; it also significantly improves someone’s overall wellbeing and chance of significantly reducing their pain.

Retraining your pain response

Here at MoreGoodDays®, we're all about helping you get a handle on your knee pain. We know it's not just about the ache in your knees – it's about how your mind, your life, and the world around you play into that pain, too.

We've got a whole plan to help you understand why your knees are hurting and what you can do about it.

Start by diving into the science of pain and learn how stress, the way you think about pain, and even your daily routines can change the way your knees feel. By getting to grips with this, you can start to take control and reduce the pain's hold on your life.

Practical techniques, based on neuroplasticity principles, are key. Examples include:

• Exercise and movement: Engaging in regular, gentle exercise can be a game-changer for easing your knee pain. It's about more than just building muscle; it's about lifting your spirits and keeping your joints flexible. You don't need to push yourself to the extreme – simple activities like a leisurely walk or a swim can significantly relieve pain and improve your day.
• Psychological support and stress relief: Mastering stress management and embracing relaxation techniques can make a significant difference. Imagine having a toolkit that helps you navigate the rough waters of physical or emotional trauma with a sense of calm. This isn't just about feeling less stressed – it's about creating a positive ripple effect that can soothe your knee pain and enhance your overall quality of life.
• Quality sleep: It's essential to identify and address factors that disrupt your sleep – be it anxiety from the day's events or a late snack – and to craft a peaceful nighttime ritual that paves the way to slumber. Achieving quality sleep is vital; it not only helps alleviate knee pain but also aids your body in coping with the full range of fibromyalgia symptoms. Incorporating aerobic exercises into your day to stimulate circulation and practicing relaxation techniques before bed can significantly promote the onset of restful sleep.

When it comes to dealing with fibromyalgia, we get that everyone's journey is unique. That's why our team is here to offer one-on-one support that's just right for you. We'll work together to find strategies that fit your life and help ease that troublesome knee pain.

Medication as an enabler

If you're battling knee pain from fibromyalgia, medications won't solve everything but might be part of your personal support team. Simple pain relievers like paracetamol and ibuprofen can take the edge off your knee pain temporarily.

Your doctor might also suggest a mix of other medications that specifically target the symptoms of fibromyalgia. These might include antidepressants, which work with your brain's chemistry to calm the central nervous system and ease pain, or muscle relaxants to reduce that gnawing feeling of muscle tension that makes knee pain even worse.

Nutrition & diet

A well-balanced diet is crucial for maintaining general wellness and could potentially ease specific symptoms associated with knee pain.

Consider limiting your intake of sugar, carbohydrates, processed foods and alcohol, and incorporating more anti-inflammatory foods into your meals to reduce pain.

More information & support

For more information and support, download our mobile app from Google Play or the App Store, or get in touch. We can help you to work towards reducing pain severity, flare-up frequency, and emotional distress.