Neuropathy vs. Fibromyalgia: Understanding the Symptoms & Differences

Neuropathy and fibromyalgia, while both involve chronic pain, have unique characteristics that make their correct identification crucial for proper treatment. Neuropathy is marked by localized pain due to nerve damage, whereas fibromyalgia features widespread pain along with fatigue and cognitive disturbances.

In this article, we will explore what both neuropathy and fibromyalgia are, and compare the similarities and differences in their symptoms and how they are diagnosed. We'll also cover how each one is treated and offer insights into treating fibromyalgia.

What is neuropathy?

Chronic neuropathic pain syndrome, or neuropathy, affects an estimated 20 million people. It is characterized chronic widespread pain, which might feel like a burning or stabbing feeling in the arms and legs. It's caused by damage to nerve fibers, especially the ones that carry sensory information¹.

In neuropathic pain disorders, the longest nerves start to break down first. This is called the 'dying-back phenomenon,'⁴ in which the nerves slowly get worse over time. The pain typically starts in the extremities – usually the hands and feet – and then moves up the arms and legs over time.

Various factors may lead to nerve damage¹, including:

• diabetes, particularly when blood sugar levels are not well-controlled
• the growth of abnormal cells or tumors
• infections
• drinking too much alcohol over a long time
• exposure to toxins
• not getting enough vitamins, for example, vitamin B12
• changes in hormone levels that throw the body off balance
• injuries
• diseases that affect kidney function.

What is fibromyalgia?

About 4 million Americans are afflicted with fibromyalgia² – a condition associated with a heightened sensitivity to pain that doesn’t necessarily originate from physical damage, unlike neuropathy. People with fibromyalgia frequently report their condition as musculoskeletal discomfort that is dispersed across various parts of the body.

Fibromyalgia is like having a sound system in the body that's turned up too high. Imagine the brain and spinal cord as the amplifier, and the nerves as guitar strings. In the case of a physical injury, it's like the strings are being played hard, causing pain. But in fibromyalgia, even if the strings are barely touched, you can feel a lot of pain because the amplifier is turned up high.

It's not that you're more sensitive to pain than other people. It's that your nervous system is working overtime.

Is fibromyalgia the same as neuropathic pain?

Fibromyalgia and neuropathy both involve pain, and people with these conditions often exhibit overlapping sensory symptoms, such as a burning sensation, tingling, and sensitivity to touch. It's also possible to have both conditions (called co-morbidities) and new studies suggest that some people with fibromyalgia also have evidence of a type of nerve pain called small fiber neuropathy³. However, these are different conditions with different causes.

So, what are fibromyalgia symptoms vs. neuropathy symptoms?

The specific sensations and severity of these sensory symptoms can vary between conditions.

Neuropathy pain usually starts with the nerves farthest from the center of your body and slowly spreads from there. But with fibromyalgia, the pain can be anywhere at any time and can also move around, meaning that your feet might hurt one day, but perhaps the pain is in your shoulders the next day. Crucially, the pain in fibro isn't coming from damaged nerves and medical scans and test will usually show that the muscles and soft tissues that hurt, don't display any signs of physical damage.

Neuropathy symptoms

People who have peripheral neuropathy often report experiencing sharp, scalding, or electric-like sensations. This is typical among classic neuropathic pain syndromes.

Those suffering from this type of discomfort may find that even a light touch can provoke significant agony due to relevant pressure-induced pain.

Symptoms linked to these nerve-related conditions typically develop gradually, starting with slight numbness and a sensation of pins and needles in the extremities, such as fingers and toes. As the condition progresses, these sensations can extend into the arms and legs. While the nature of the condition is progressive, there is a chance for the symptoms to improve if the underlying cause is effectively treated.

Fibromyalgia symptoms

People with fibromyalgia encounter a unique kind of pain along with other symptoms that set it apart from neuropathic discomfort. Symptoms include:

• a pervasive ache that seems to infiltrate muscles and joints
• sleep disruptions
• difficulty with concentration and memory, often called 'fibro fog'
• emotional ups and downs.

These symptoms together weave a complex tapestry that defines the condition.

The onset of fibromyalgia symptoms can be insidious, often starting and then later flaring up after physical trauma or significant stress, though pinpointing a single triggering event can be elusive.

Those affected by fibromyalgia generally report enduring both chronic fatigue and extensive pain in the body's muscles and bones. These primary symptoms are frequently accompanied by issues related to sleep and other physical complaints.

How do I know if I have fibromyalgia or neuropathy?

Should you consistently feel sensations such as numbness, a pins and needles effect, tingling, or weakness in the extremities, these could be signs of peripheral neuropathy. On the other hand, if such symptoms are intermittent rather than persistent, they might suggest fibromyalgia instead.

How is neuropathy diagnosed versus fibromyalgia?

Diagnosing conditions such as neuropathy and fibromyalgia is challenging due to the similarity of their symptoms. Your doctor will want to know about your experiences and symptoms, and might use questionnaires as well as tests to assess your pain levels and sensory symptoms.

How neuropathy is diagnosed

To figure out if you have neuropathy, doctors use different tests, such as:

• nerve conduction studies (NCS) and electromyography (EMG), to check how fast and strong your nerve signals are and how your muscles respond
• skin biopsies to look at the tiny ends of your nerve fibers
• blood tests to look for other health issues that might cause neuropathy.

How fibromyalgia is diagnosed

Unlike neuropathy, lab tests can't determine if you have fibro or not, although they are important for ruling out other conditions. Your healthcare practitioner will want to hear about your symptoms and how they impact your life. Tracking your symptoms can help.

The doctor might use the widespread pain index and the symptom severity scale. This is a series of questions about your symptoms, which was developed by the American College of Rheumatology in 2010. These questions can help your doctor to understand how much pain you're in and how it's affecting your life. To be diagnosed with fibromyalgia, you need to have been feeling widespread pain for at least three months, and doctors need to be sure there's no other reason for your pain.

Current guidelines also aim to capture the full scope of a person's experience⁵, including pain, fatigue, stomach troubles, mood disturbances, brain fog, and any of the other many varied fibromyalgia symptoms that people can experience.

Fibromyalgia & comorbidities

People who live with fibromyalgia frequently encounter comorbidities – other conditions that are present in addition to fibro.

Psychological challenges, including depression and anxiety disorders, impact those with fibro to a greater extent than those suffering from conditions such as diabetic neuropathy⁷. This could be because the persistent nature of fibromyalgia frequently leads to more intense psychological impacts, which can relentlessly impact your everyday activities and overall wellness.

Those diagnosed with fibromyalgia often experience a variety of other associated health conditions, including migraines, disorders of the temporomandibular joint (TMJ) in the jaw, and irritable bowel syndrome.

Among these accompanying issues, sleep problems stand out as being particularly widespread among those with fibromyalgia compared to people dealing with neuropathy.

Treatment & management strategies

Addressing chronic pain conditions such as neuropathy and fibromyalgia often involves a multidisciplinary approach that combines medication along with non-medicated treatments such as retraining your nervous system or participating in physical therapy and exercise.

Treating & managing neuropathy

The management of neuropathic pain includes an array of medications such as:

• analgesics
• antidepressant drugs
• medications designed to control seizures
• creams and patches applied to the skin.

These medications aim to alleviate the pain associated with neuropathy, thus improving quality of life.

Innovative treatments such as scrambler therapy⁸ and spinal cord stimulation⁹ have shown promise in the relief of neuropathic pain. Additionally, physical therapy plays a crucial role in enhancing movement and balance.

Treating & managing fibromyalgia

Retraining your pain

To reshape your brain's reaction to pain, it's essential to understand that pain is not solely a physical experience but also influenced by your mental, emotional, and social environment.

Learning about what sets off your pain, whether it's due to tension, certain mindsets, or actions, is the first step. Recognizing these triggers allows you to modify them through dietary changes, better sleep habits, physical activity, or by employing neuroplasticity techniques to alter your brain's perception of these triggers. Through consistent practice and commitment, you can progressively transform your brain's response, which can lead to a decrease in both the severity and the influence of your pain.

Retraining your pain can include the following techniques.

Stress management

While completely removing stress from your life isn't possible, learning to better manage it and minimize stress can really help reduce the amount of pain that you feel.

There are many ways to reduce stress, and what you choose will be specific to your unique circumstances. However, some great techniques that can help most people include cognitive behavioral therapy (CBT) and mindfulness meditation to help you think more healthily, learn to focus on the present moment, and find ways to relax. It's also good to talk to friends, or a counselor, or join a group where you can share your feelings and get support.

Movement & exercise

Movement and exercise might seem tough at first, but they're extremely helpful for dealing with pain. When you get moving, you'll likely start to feel happier, have more energy, and sleep better. It's all about finding activities that you enjoy and that mare manageable for where you're at right now. This could be something like yoga, dancing, or working in your garden.

Doing stretches and low-impact exercises like walking can help loosen up your muscles. As you get more flexible, you might notice some pain relief which can make you feel better.

Start easy and slowly increase what you do as you get stronger. Be kind to yourself while you're doing this. If you take it slow and listen to what your body tells you, you'll find that you can do more and more (in general in life, not just movement!) without hurting.

Sleep quality

Sleep is a key piece in handling your fibromyalgia. Think of it as an important part of taking care of yourself that can actually make your pain less.

Most people with fibromyalgia, we're talking more than 9 out of 10, really struggle to get the kind of deep sleep that helps the body recover.

• Try to sleep for about eight hours each night and get up and go to bed at the same times every day.
• If you nap, keep it short. A quick rest can be refreshing and won't mess up your sleep at night.
• Be active during the day. It'll make it easier to fall asleep when it's bedtime.
• Cut down on using phones or computers before you go to sleep. This helps your brain calm down and lets you fall asleep easier.
• Turn your bedroom into a calm place. It should be dark and quiet so you can sleep without interruptions.
• Be careful with caffeine, especially later in the day. Caffeine can stick around in your body for a long time and keep you awake.
• Don't eat a lot or drink alcohol right before you go to bed. This can mess with how well you sleep.
• And don't forget to relax your heart, body, and mind in other ways too. This helps with your overall sleep habits and managing your symptoms better.

Physical therapy approaches

Applying heat through warm compresses can serve as a gentle introduction to exercise and stretching routines. This technique eases the pain that comes with fibromyalgia, making essential physical activities more manageable and effective for those dealing with the condition's characteristic sensations of tingling pain.

More information

At MoreGoodDays®, we embrace a comprehensive strategy to assist those living with fibromyalgia in navigating their daily lives. We recognize the significant impact this condition can have on every facet of existence. Our tailored techniques are designed to address your unique challenges. Through our educational content and skill-building for self-management, you will gain an enriched understanding of fibromyalgia and learn to manage its symptoms more effectively.

Psychological support is also a key component of our services, including cognitive behavioral therapy (CBT) and methods for reducing stress, which bolster your resilience against the emotional toll of fibromyalgia. Our commitment is to accompany you on your path to better health and more joyful moments, despite the challenges of this persistent illness.

For instant access to portions of our content and an overview of available support mechanisms at any time, make sure you download our complimentary mobile application from either the Apple App Store or Google Play Store.