Sensory Symptoms in Fibro
Fibromyalgia is synonymous with widespread muscular aching, but pain is not your only problem. Sensitivity to bright lights, loud sounds, strange odors, and light touch are sensory symptoms that make living with fibromyalgia worse. Naturally, it’s helpful to understand what causes your sensory sensitivities so you can learn to coexist with them. In fact, treatment studies show certain medications can ease sensory-related symptoms in fibromyalgia.
Why Senses Are Amplified
Research pinpoints several abnormalities to explain why you are sensitive to all kinds of sensory stimuli. In a nutshell, you have neurotransmitter chemical imbalances and a hyper-responsive nervous system. But this is an oversimplification. Based on published studies in fibromyalgia, four mechanisms explain your sensory overload symptoms:
Chemical Imbalance: Signals entering your spinal cord or your brain can be muted by the transmitting chemical GABA. Conversely, glutamate amplifies signals. Your spinal cord and brain have too little GABA and an abundance of glutamate.1,2 As a result, the strength of the signals picked up by your eyes, ears and nose is increased.
Spinal Cord Failure: Your spinal cord is designed to filter out nuisance signals before they reach the brain. It’s a barricade requiring signals to reach a threshold level of importance before the cord relays it to the brain. This system is defective in fibromyalgia and explains your low pain threshold. In fact, all sensory signals are carpooling across the cord’s broken barricade and being transmitted to the brain. The net result is a brain bombarded with too many sensory inputs.
Brain Overreacts: When sensory signals reach the brain, your insula prioritizes them so unimportant inputs get limited attention. Unfortunately, showing fibro patients bright colors leads to exaggerated insula activity.3 In fact, the greater your insula overreacts, the greater your sensory symptoms and fibromyalgia pain.
Greater Sympathetic Activity: After your brain falsely attributes sensory signals as “urgent,” it transmits this message to your sympathetic nerves. These nerves convey messages from your brain to your organs, including your eyes, ears and nose. Subjecting fibromyalgia patients to auditory stimuli shows both a heightened brain response and greater sympathetic reactivity.4 The latter can unfavorably impact the way your eyes, ears and nose respond.
Common Sensory Symptoms
So often, people with fibromyalgia are wrongly portrayed as exaggerating their symptoms. This isn’t true! The studies above, as well as others, provide objective evidence for your sensory sensitivities.5 And despite what people might think, studies show that fibromyalgia patients don’t over-report their symptoms, including sensory-related ones.
Struggling to grasp how your altered neurological responses cause your eyes, ears and nose to be sensitive? Keep in mind that increased sympathetic nerve activity can cause:
- pupil dilation (making them more sensitive to light)
- altered inner ear blood flow (impacting sound sensitivity)
- increased transmissions to your olfactory center (enhancing smell perception)
While the specific mechanisms responsible for your sensory amplification are unclear, they are every bit as real as your pain.
There is no dispute that you have sensory symptoms, but is it worse in people with fibromyalgia than other chronic pains? And if so, what are some of the most pronounced sensory-related complaints? One study found fibromyalgia patients have greater sensory problems compared to other chronic pain patients.6 The most annoying environmental triggers according to the fibromyalgia patients are:
Flashing light
Food odors/smells
Glare
Multiple screens on display
Artificial light
Fluctuating temperature
Mechanical background noise
Bright light
Does this mean that fibromyalgia patients are not sensitive to sunlight, perfume, loud music, and other sensory inputs? No. The above is simply a list of the most prominent offenders.
Fibromyalgia and chronic pain patients were also asked which sensory stimuli they try to avoid in public places. One answer separating fibromyalgia patients from others with chronic pain was: BRIGHT DECOR.
Ear-Related Sensitivities
Sensitivity to noise is likely one of many auditory problems you encounter. As a result, the more common ear-related sensory symptoms in fibromyalgia deserve more attention.7
Tinnitus is the most frequent diagnosis, with a prevalence ranging from 30 to 80 percent. The symptoms include buzzing, hissing, or ringing sounds. Ear pressure pain and the feeling of fullness is estimated to occur in one-third of patients. Dizziness/vertigo occurs in 20 to 80 percent of patients. Vertigo is the hallucination of movement (the room is spinning) or feeling as though you are about to fall. This symptom is often tied to balance issues, and it is no coincidence that fibromyalgia patients are six times more likely to fall than healthy people.
While reduced noise tolerance, tinnitus, vertigo, and ear pain are related to increased sensory sensations involving the ears, some patients have the opposite problem: hearing loss. The prevalence is roughly 15 percent in fibromyalgia and risk of hearing loss is increased by the following conditions: diabetes, hypertension, hyperlipidemia (e.g., high cholesterol), and depression.8 Taking anti-epileptic drugs, opioids, aspirin, and diuretics are also risk factors.
If you have auditory symptoms, it’s a good idea to get audiological testing to make sure you don’t have a serious ear disease. Hearing loss needs to be treated. However, if your hearing-function tests are normal, take solace in knowing this is often the case for fibromyalgia patients. So, what gives?
Measuring how fast the brain responds to auditory stimuli helps explain why your ears are sensitive, yet devoid of disease. In a nutshell, the fibromyalgia brain is much quicker to respond to sound than healthy controls. This can lead to additional auditory noise or distortions like tinnitus and vertigo, as well as sound sensitivities. The four mechanisms described above are likely to blame.
Managing Sensory Overload
Studies show sensory inputs amplify painful symptoms in fibromyalgia patients. In fact, subjecting patients to aversive visual and auditory stimuli leads to higher pain ratings. Although there are no reports involving odor stimuli, nasty smells likely generate more pain as well.
Medications to treat your pain may also reduce your sensitivities. GABA-boosting medications (gabapentin and pregabalin) combat the detrimental impact of glutamate. Duloxetine and Savella increase both serotonin and norepinephrine to help your nervous system inhibit sensory signals. Fibro patients on these meds display less sensory sensitivities. Unfortunately, the side effects may be worse than your sensory symptoms. In addition, the GABA drugs increase your risk of hearing loss.
Self-help measures are your best symptom management option. This approach is no different than placing a cushion on your seat or putting a heat wrap around your shoulders. Both techniques decrease the number of noxious signals entering your nervous system and lead to reduced pain. But don’t just cater to your achy muscles; protect your eyes, ears, and nose from pain-producing inputs as well.
You are the best judge of which self-help measures might benefit you. However, here are a few ideas to get you started:
- Dry eyes are more light-sensitive, so keep them moist with artificial tears. Get a blue-light screen protector for your computer monitor and switch your cell to dark mode in the evening.
- Try to cancel out tinnitus and other noise with music you enjoy or soft sounds. You can also try a sound generator.
- You know what smells wrangle your senses; just avoid them whenever possible.
Every step you take to reduce the amount of aversive sensory inputs to your nervous system will ease your fibromyalgia symptoms. Otherwise, your spinal cord will use a megaphone to transmit these signals to your overloaded brain!
Helpful Resources
The above research and self-help ideas will help you understand your deal with your sensory sensitivities. See our articles about the medications mentioned, as well as other resources to help you reign in your fibromyalgia symptoms.
Medications – this section contains advice from treatment experts on how to minimize the side effects of gabapentin, pregabalin, duloxetine, and Savella.
Removing Food Additives – this article describes how to eliminate the sensory-enhancing glutamate chemical from your diet
Alternative Therapies – this section contains several articles on nondrug approaches to treat your fibromyalgia pain and other symptoms
Fibromyalgia Headache Treatments – learn what you can do to tame your head pain, including migraines associated with light sensitivity (or aura)
Symptoms – read about other symptoms that make living with fibromyalgia a challenge
Managing Fibromyalgia Pain – provides a variety of approaches to help you get a handle on your symptoms
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References for Fibromyalgia Sensory Symptoms
- Foerster RB, et al. Arthritis Rheum 64(2):579-583, 2012. Free Report
- Harris RE, et al. Arthritis Rheum 60(10):3146-3152, 2009. Free Report
- Harte SE, et al. PAIN 157(9):1933-1945, 2016. Free Report
- Marinkovic K, et al. Neurobiol Pain 14:100140, 2023. Free Report
- Staud R, et al. J Pain 22(8):914-925, 2021. Free Report
- Dorris ER, et al. Front Pain Res 3:926331, 2022. Free Report
- Skare TL, Freire de Carvalho J. Rheumatol Ther 11(5):1085-1099, 2024. Free Report
- Le TP, et al. PLOS ONE 15(9):e0238502, 2020. Free Report