By Madeline R. Vann, MPH
Medically Reviewed by Lindsey Marcellin, MD, MPH
When you have fibromyalgia, it may seem as if you just can’t get a break from the pain — which may include an aching back. As many as two-thirds of people with chronic low back pain also have fibromyalgia. Looking at the numbers from the other direction, up to 49 percent of people with fibromyalgia have lower back pain. In fact, back pain is so prevalent among people with fibromyalgia that it was once one of the symptoms doctors looked for in making a fibromyalgia diagnosis.
There’s no doubt that living with fibromyalgia is challenging enough on its own, let alone when you have back pain. But it may make you feel a little better to know there is an explanation for the intensity of the pain you’re going through.
“Both back pain and fibromyalgia belong to a group of disorders called central hypersensitivity syndromes,” says pain management specialist Ronald Staud, MD, professor of medicine at the University of Florida in Gainesville. Although the roots of the two conditions differ — for example, back pain could be caused by a damaged vertebral disk — the pain experiences of the two conditions bear some similarities. Among them is the sense that these chronic pain conditions cause you to be on a “high alert” setting of sorts (doctors call it hyperarousal). And then, to top it off, the pain wears you down, causing fatigue, depression, and anxiety that make living with fibromyalgia and back pain all the more draining.
“The hyperarousal is really a normal response,” says Dr. Staud. Normal, yes, but it throws a monkey wrench into finding the right combination of treatments to ease two very painful problems.
One essential is getting an accurate diagnosis of your back pain. According to Staud, many physicians who treat fibromyalgia can also assess back pain’s possible causes. However, ask for a referral to a pain specialist if you have any concerns about your doctor’s ability to parse out the factors contributing to your back pain and prescribe the appropriate medical treatment.