Muscle Spasms in Fibromyalgia & Chronic Fatigue Syndrome

A Painful Symptom

Muscle spasms can be a source of considerable pain in many people with fibromyalgia and chronic fatigue syndrome. Our muscles clench and just won't relax, sometimes in spite of multiple treatments. These conditions often show up alongside others, like irritable bowel and irritable bladder syndromes, that involve smooth muscle spasm.

I almost always have muscles in spasm, mostly in my neck, lower back, and hips.

Taut, hard, painful muscles can keep me awake and limit my activity significantly. In addition to the constant ones, I get them randomly around my body.

They can hit out of the blue, too. I can't count how many times I've been in the middle of something and feeling fine, only to be sidelined by a sudden muscle spasm. It can happen while I'm walking, sitting, or lying down and I haven't found any way to predict them.

I've heard enough stories from other people with these conditions that I know I'm not alone. So what can we do about it?

Treating Muscle Spasms

The most common treatment for muscle spasms is muscle relaxants such as Flexeril (cyclobenzaprine). In my personal experience, it keeps things from getting too bad, but it's certainly not a complete fix.

Some supplements are believed to help with muscle spasms, including:

As usual with supplements, we don't have solid evidence that they're effective and there's little to no research on them specifically for fibromyalgia or chronic fatigue syndrome.

Some people get relief from:

There's a lot you can do at home, too, including:

Many of these treatments can have effects on other symptoms as well.

What Causes Muscle Spasms?

Researchers haven't gotten to the root of our muscle spasms yet. However, we do have some studies showing a link to myofascial trigger points. (These are different from the tender points used to diagnose fibromyalgia.)

Trigger points (TrPs) are small, ropy bands of muscle tissue that are in constant spasm but can get better or worse at times. They generally result from and injury that doesn't heal properly. Someone with chronic pain from multiple TrPs may have myofascial pain syndrome, a condition that's strongly linked to fibromyalgia.

An important characteristic of TrPs is that they can cause referred pain. In other words, they cause pain away from where they are, so an active trigger point in your neck may cause what feels like sinus pain around your eyes. (Trust me on this one. I know it well!) So when a doctor looks at where it hurts, there's nothing wrong. Sound familiar?

In one study, researchers were able to recreate the seemingly random pain of fibromyalgia by manipulating TrPs.

That suggests that at least some of our pain may be caused by TrPs.

The good news there is that TrPs can be treated and even gotten rid of. You can learn more about that here:

Another possible cause of muscle spasms is our dysfunctional nervous systems. It's possible that our nerves send signals improperly and cause twitches or spasms.

Hmm, I Wonder....

As I've learned more about these conditions and how the human body works in general, I've come across a couple of things that, taken together, make sense. At least to me. We don't have any research on this that I can find, so these are just my own musings.

Did you know that it takes more energy for a muscle to relax than to contract? In fact, it takes twice as much. Weird, eh? Here's how it works:

  • When a muscle contracts, small pouches in the cells release calcium.
  • For the muscle to relax, the cell needs to pump the calcium back into the pouch.
  • When energy is low, the cell can't perform that job and the muscle stays contracted.

Given the energy deficits of fibromyalgia and chronic fatigue syndrome, I can't help but wonder if there's a connection.

More and more, researchers are looking at how our cells and the mitochondria within them function. The theory that our illnesses involve mitochondrial dysfunction is becoming more accepted. So is something misfiring in the minuscule parts of cells that doesn't allow our muscles to un-clench?

According to some research, supplements that can increase cellular energy and mitochondrial function include:

(You'll notice that magnesium and B-12 are also listed as helping with muscle spasms.)

Living with Muscle Spasms

While you may not be able to eliminate muscle spasms, you have a lot of treatment and management options that may help you feel and function better.

As always, talk to your doctor, experiment with a variety of safe treatments, and keep doing what works.

Sources:

Ge HY, et al. Arthritis research and therapy. 2011 Mar 22;13(2):R48. Reproduction of overall spontaneous pain pattern by manual stimulation of active myofascial trigger points in fibromyalgia patients.

Ottawa (ON): Canadian Agency for Drugs and Technologies in Health, Feb. 2015. CADTH Rapid Response Reports. Long-term use of cyclobenzaprine for pain: a review of the clinical effectiveness.

Smith NL. Journal of pain & palliative care pharmacotherapy. 2004;18(4):31-45. Serotonin mechanisms in pain and functional syndromes: management implications in comorbid fibromyalgia, headache, and irritable bowl syndrome - case study and discussion.

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