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Sensory Overload

Is Sensory Overload Part of Your Fibromyalgia?

You expect to have painful muscles everywhere with fibromyalgia. Even if your discomfort fluctuates from day to day, this symptom is always present. The pain of fibro is amplified, as though the volume control knob is turned up as high as it could go. But there is much more to fibromyalgia than just the pain. Chances are, you have other sensory-related symptoms that are roaring off the charts and making your fibro all the more difficult to manage.

Take, for example, the sensory-related symptoms below. Most patients with fibromyalgia will recognize them as an added source of annoyance.

  • numbness and tingling sensations in your extremities
  • swelling sensations—feeling as though one’s limbs are made out of gelatin
  • burning skin—just like a bad sunburn, despite no redness or visible rash
  • sensitivity to loud sounds (you are always asking family members to turn down the volume)
  • odors bother you much more than they do everyone else (your sense of smell is heightened)
  • bright lights bother you, maybe even contributing to your headache, especially if you are walking in a colorfully lit shopping mall
  • dry, burning eyes—sometimes they hurt so badly, they burn, but your doctor can’t find anything wrong with them and has ruled out medication side effects
  • sensitivity to tastes

With regards to eye-related symptoms, Daniel Clauw, M.D., director of the University of Michigan’s fibromyalgia research center, says he is working with an ophthalmologist on a project to show that people with dry, itchy eyes whose tests are normal have a regional equivalent of fibromyalgia (it’s like irritable bowel or interstitial cystitis of the eyes). “This disease spares no area of the body, which only makes sense because we get sensory input from everywhere, including the eyes.”

Clauw believes that there is an alteration in the way the brain processes all sensory-related input, not just pain. And, just as your pain signals are amplified in fibromyalgia, so are all of your other sensory inputs for touch, sight, sound, and smell. This would mean that whatever is causing your pain to be amplified is also linked to the magnification of your other sensory symptoms, and a research report points to this connection.

A study by Michael Geisser, Ph.D., also at the University of Michigan, shows that the pain levels of fibromyalgia are directly tied to these other annoying sensory symptoms.1 Patients with a greater number and severity of sensory symptoms (such as those highlighted above) tended to predict higher pain scores, a greater number of physical symptoms, and reduced functional capacity. In other words, the more your sensory symptoms become amplified, the worse your fibromyalgia will become.

Treatments geared at dampening the sensory amplification process may be more effective than tending to each annoying symptom individually, says Geisser. He suggests using medications that operate systemically to tame the signals in the nervous system, rather than to use local or topical approaches to relieve the symptoms.

“Certain agents that may activate the spinal cord’s pain inhibitory system, such as Cymbalta and Savella, may also normalize sensations in other sensory pathways,” says Geisser. “For example, studies have shown that these drugs also decrease the number of subjective symptom complaints in chronic pain patients.”

Medications that work to help filter out the number of sensory signals being amplified in the nervous system may also be beneficial. Examples include Lyrica and Neurontin, which are similar drugs in the anticonvulsant class. If you have already tried these two meds to treat your fibromyalgia pain but they caused too many side effects, one might still work to ease your amplified senses using a different approach. Consider talking to your doctor about taking a smaller dose that is less likely to cause side effects and only take it at bedtime. Either drug should aid with sleep, while potentially toning down those annoying sensory symptoms.2

While Geisser has shown that your level of fibro pain is closely tied to how many sensory symptoms you are battling, there are other research questions he would like to explore. Can the above mentioned medications used to treat fibromyalgia lead to improvements in auditory function tests so that patients are less sensitive to loud sounds? What about the medication effects on other sensations, such as responses to odors or visual stimuli (especially bright lights)? Answers to these questions could help zero in on the best possible treatments for these pesky symptoms.

1. Geisser ME, et al. Comorbid somatic symptoms and functional status in patients with fibromyalgia and chronic fatigue syndrome: sensory amplification as a common mechanism. Psychosomatics 49:235-242, 2008.
2. Russell I, et al. The effects of pregabalin on sleep disturbance symptoms among individuals with fibromyalgia syndrome. Sleep Med 10(6):604-10, 2009.

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