How Showering Can Worsen Symptoms of Fibromyalgia and ME/CFS

• Exertion
• Too Much Relaxation
• Heat Sensitivity
• Blood Pressure Drops
• Nerve Response
• What You Can Do

If you have fibromyalgia or chronic fatigue syndrome (ME/CFS), you may experience new or exacerbated body aches, weakness, dizziness, and other symptoms of your condition during or after a shower.

This may happen for several reasons, including heat sensitivity, the energy it takes to perform a simple task like this, how your nerves respond to the water flow, and even an abnormal drop in blood pressure.

This article explores why the shower you thought might ease your fibromyalgia or chronic fatigue symptoms does just the opposite, as well as what you can do to avoid these effects.

Exertion

A shower takes more energy than people tend to recognize. You’re standing the whole time. You do a fair amount of bending, stretching, and reaching while vigorously lathering up your head and body.

Most people aren’t impacted by this. But for those with ME/CFS, even small amounts of exertion can be too much. That’s due to a symptom called post-exertional malaise (PEM)—a defining characteristic of this disease.

Persons who experience PEM have trouble recovering after normal activities of daily living, such as showering, putting on clothes, or doing the dishes.

Symptoms of PEM may include severe fatigue, flu-like feelings, pain, and/or worsening of other associated symptoms.¹

People with fibromyalgia don’t have post-exertional malaise, but some have a similar type of exercise intolerance.²

Too Much Relaxation

Both of these conditions can overlap with sleep disorders, including insomnia, sleep apnea, and restless legs syndrome.³⁴ They also both involve unrefreshing sleep.

The hot water of a shower can be relaxing, which is great when it comes to tight muscles and connective tissues. But relaxation is not too helpful if you’re dealing with profound fatigue because of these issues.

If you are going to shower, avoid mornings, when you’re especially fighting to get going.

Temperature Sensitivity

Temperature sensitivity is associated with both fibromyalgia and ME/CFS. It’s suggested that abnormalities in the autonomic nervous system make it hard for the body to keep its temperature in the normal range.

When you get heated up by a hot shower, it’s a lot of work for the body to cool back down to normal. Some people get so overheated that they sweat profusely after a shower.⁵

In some cases, temperature sensitivity can lead to other symptoms to kick up as well, so it pays to avoid triggering it.

Blood Pressure Drops

People with ME/CFS are prone to dizziness thanks to a symptom called orthostatic intolerance. Basically, that means they get dizzy upon standing up. It’s caused by an abnormal blood-pressure drop.⁶

Other symptoms of orthostatic intolerance may include lightheadedness, weakness, racing heart, and/or vision changes (blurred vision or seeing black or white spots).⁷

The heat of the shower combined with the motions of washing can have your body working overtime to keep your sense of balance.

Persons with fibromyalgia may also experience orthostatic intolerance.⁸ However, there are other causes of dizziness in fibromyalgia that are different from those that cause it in ME/CFS.

Heightened Nerve Response

The pressure of water hitting your skin can get your nerves riled up.

For some, it hurts while they’re under the spray. Others might not hurt until after a shower when they feel the cumulative effects of stimulating their overreactive nerves.

Erroneous pain signals can cause widespread body aches. The pain may be described as burning, aching, stabbing, or tingling.⁹

This phenomenon is called allodynia, which is pain caused by something that wouldn’t normally hurt. There’s a thermal form of allodynia that could make the heat of a shower even harder to tolerate.

Allodynia is almost universal in fibromyalgia and some people with ME/CFS experience it, as well.¹⁰

What You Can Do

Taking a bath is an easy solution to some of the problems that showering can cause you.

This is especially true for dizziness, exertion, and a heightened nerve response, since you can rest while cleaning yourself and aren’t under a steady stream of water.

A bath also tends to steam up the bathroom less, so you may have an easier time cooling off when you get out.

If you don’t have time for a soak, don’t have a bathtub, or simply prefer showers, these tips can help:

• Use a shower stool: Sitting down means you’ll be doing less bending and stretching, and it could prevent dizziness while conserving energy.
• Use cooler water in the shower: If hot water has a negative impact on you, you can always dial the temperature down.

In either case, it might be better to bathe or shower in the evening instead of in the morning. This will prevent you from becoming too relaxed when you’re trying to find energy to start the day and may help you get better sleep at night.

When taking a bath or a shower requires more exertion than you can muster, have someone help you in and out of the tub or shower, or use body-cleansing wipes and dry shampoo to freshen up.

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By Adrienne Dellwo
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.