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People with fibromyalgia usually experience pain and stiffness, fatigue, problems with thinking and memory, and sleep disturbances. Less common symptoms include tingling sensations and headaches. For some people, itching can also be a problem.
Experts do not know exactly what causes fibromyalgia, but one theory is that the nerve pathways become oversensitized. As a result, people with fibromyalgia feel pain more intensely than those without the condition.
Read on to find out more about the link between fibromyalgia and itching, as well as how to relieve this symptom.
Itching is relatively rare as a symptom of fibromyalgia.
In a study looking at the frequency of skin-related issues in people with fibromyalgia, only 3.3% of people reported that they experienced itching with no identified cause.
Other skin problems that affected the participants included:
- Excessive sweating: 32%
- Non-irritating skin Inflammation: 9.1%
- Burning sensation of the skin or mucous membranes: 3.4%
- Skin lesions for various reasons: 1.9%
- Unusual skin sensations: 1.7%
People with fibromyalgia are more sensitive to pain, sensation, and touch than those without the disorder. As a result, minor skin problems may trigger prickling or itching.
The fibromyalgia diagnostic criteria
The American College of Rheumatology provide criteria for diagnosing fibromyalgia. Experts have modified and updated these criteria many times during the early 21st century, adding new signs and symptoms.
The criteria currently state that to receive a diagnosis of fibromyalgia, a person has to have symptoms that remain at a similar level for at least 3 months. They also have to experience pain that affects a minimum of seven out of 19 body areas.
A doctor will score the number of areas where a person feels pain using a scale of 0–19, and this will give the person’s Widespread Pain Index (WPI) score.
After determining the WPI score, the next step is to determine the Symptom Severity (SS) score. For part one of the SS score, the doctor will rate specific areas from 0–3, where 3 is the most severe.
These areas are:
- waking unrefreshed
- cognitive, for example, changes in thinking or memory
In part two of the SS score, the doctor will check the other symptoms that the individual has experienced in the past week and allocate a score accordingly. Itching is among these many possible symptoms.
The doctor will calculate a final number using the WPI and total SS scores to work out whether the person has fibromyalgia. As part of the diagnosis, they will also need to rule out any other health problems that could explain the pain and other symptoms.
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Experts do not know why itching occurs with fibromyalgia, but several factors may play a role.
Central nervous system
The central nervous system (CNS) comprises the brain, spinal cord, and nerves. The CNS communicates information all around the body through a network of nerve cells.
Scientists think that people with fibromyalgia experience changes in the way that the CNS processes their pain messages.
These changes may develop because of high levels of certain brain chemicals called neurotransmitters, which signal pain.
Researchers also believe that the pain receptors in the brain can develop a muscle memory of the pain, which can cause them to become more sensitive and overreact to pain signals.
Itching may occur because fibromyalgia activates certain nerve fibers. Itching and pain share a common pathway that runs through the spinal cord. Pain and itchiness also activate the same sensory brain areas.
A person who is sensitive to pain may also have a sensitivity to itchiness.
Constant itching may set off a “scratch-itch cycle.” Initially, scratching relieves the itch, but continual scratching damages the skin. This damage makes the itching worse, so the person scratches more, resulting in increased itchiness.
Neurotransmitters are chemical messengers that control communication throughout the brain and body.
Research into serotonin’s role in the skin found that abnormal levels of serotonin caused itching in mice.
The researchers also noted that when the body releases serotonin in response to pain, this activates certain receptors that cause itchiness. Scratching the itch causes the release of serotonin as a pain reliever, which activates the receptors again and causes more itching.
Treatment with selective serotonin reuptake inhibitors (SSRIs) may help reduce skin itching. Examples of these drugs include sertraline (Zoloft) and fluoxetine (Prozac).
Side effects of treatment
Medications for the treatment of fibromyalgia can cause itching in some people. These drugs include pain relievers, antidepressants, and antiseizure drugs.
- Acetaminophen (Tylenol): This drug can cause skin rash, hives, or itching in rare cases.
- Ibuprofen (Advil): Itching is a common side effect of ibuprofen.
- Naproxen (Aleve): Many people who take this medication experience itching as a side effect.
- Tramadol (Ultram): Itchy skin is a common side effect.
- Duloxetine (Cymbalta) and milnacipran (Savella): Some people experience sensations of burning, crawling, itching, numbness, prickling, “pins and needles,” or tingling.
- Pregabalin (Lyrica): Itching is a rare side effect of pregabalin.
If a person notices itching after starting to take fibromyalgia medications, they should speak to a doctor. The itching could be a sign of an allergic reaction.
In some cases of itching, the doctor may adjust the dosage or recommend an alternative medication.
Persistent itching can interfere with sleep, and a lack of sleep could worsen the symptoms of fibromyalgia. Continued scratching may also result in infection.
The following measures may provide relief for damaged skin that results from scratching.
Moisturizing the affected skin at least once a day, especially after bathing or showering.
Avoiding perfumed products, such as scented soaps and moisturizing lotions.
Using cooling creams or gels on the skin.
Applying anti-itch creams or lotions in the short term. These should contain at least 1% hydrocortisone. Calamine and capsaicin may also help.
Using anesthetic skin creams and lotions, such as pramoxine (Caladryl), to reduce itching.
Trimming the nails and wearing gloves at night to prevent scratching.
Applying cool, wet compresses to the affected area.
Taking a lukewarm bath with baking soda, uncooked oatmeal, or colloidal oatmeal in it.
Minimizing stress through therapy or relaxation methods, such as meditation or yoga.
Aiming for comfort by wearing loose clothes and keeping the bedroom cool at night.
If a person with fibromyalgia is experiencing persistent itching, they should speak to a doctor about their symptoms.
There are no guidelines for treating itching in people with fibromyalgia. However, a doctor can provide treatment once they establish the cause of an itch.
Medications to manage pain often reduce itching, too. Medications to treat fibromyalgia pain include:
Pain relief medication: Acetaminophen, ibuprofen, and naproxen sodium are available over the counter. A doctor may sometimes prescribe tramadol.
Antidepressants: Duloxetine and milnacipran can help reduce pain.
Antiseizure drugs: Gabapentin (Neurontin) and pregabalin can also provide pain relief.
If one medication causes itching, a doctor can recommend a different dosage or an alternative drug.