Keeping Your Body Aches Under Control

by Kristin Thorson, Editor, Fibromyalgia Network
Posted: August 23, 2011

When you tense your upper body muscles to scrub the outdoor grill or work at the computer, you might expect your neck and shoulders to ache afterwords. But why would your leg muscles start to hurt if they didn’t even get a workout? A new study by Hong-You Ge, M.D., Ph.D., of Denmark explains why a two-minute contraction of the shoulder muscles can increase leg pain in people with fibromyalgia.*

Sustained muscle contractions are known to trigger the release of pain-relievers into the spinal cord to reduce feelings of achiness in those muscles that are getting the workout. It’s a natural process that soothes pain, at least in healthy subjects. But this system that provides analgesia after exercise appears to be working the wrong way in fibromyalgia patients.

Study participants were asked to contract the large shoulder muscles in their upper back until their muscles gave away to fatigue. Twenty-two fibro patients were compared to the same number of healthy control subjects. Everyone in the study was middle-aged, so age was not a factor.

The upper shoulder muscles’ sensitivity to pressure pain was measured before and immediately after the contraction, as well as 20 minutes later. Pain sensitivity was also checked in a lower leg muscle that was relaxed the entire time. The research team predicted that the spinal cord was misinterpreting the messages from the contracting muscles and making pain worse throughout the body in people with fibromyalgia.

The brief muscle contraction in the healthy group produced less pain in the shoulder area right after the exercise and 20 minutes later. This is what should happen when taxing one’s muscles, so that waste products like lactic acid don’t leave people hurting. If this did not happen, people would learn to avoid exercise whenever possible and that wouldn’t be healthy. Pain sensitivity in the lower leg was unaffected. The results were quite the opposite for those with fibro.

Pain levels started out much higher in the group of fibromyalgia patients (as expected). In addition, the spinal cord did not kick in to relieve post-exercise soreness in the shoulders. Worse yet, pain sensitivity increased significantly in the leg muscles that were relaxed throughout the study.

What does this mean? The system in the spinal cord that people rely upon to ease post-exercise discomfort seems to be responding to workouts by increasing the pain in fibro. So, if you are a fibro patient on your feet all day long, your activity can cause sore leg muscles and also make other muscles hurt, such as those in your arms.

Exercise is an essential part of staying fit and healthy, but it is hard to do if it increases your pain, as this study demonstrates. The trick is to not overwork any of your muscles. This explains why fibromyalgia patients state that keeping their pain under control requires frequent rest breaks and changing positions to avoid straining any muscle group.

Increasing physical function has to be done extraordinarily slow in fibromyalgia patients just to keep the pain levels stable. As your muscles get bigger and stronger, your body will be able to sustain more activity before the spinal cord decides to amplify your pain. Improving fitness has to be done very carefully and gradually, or increased muscle aches will constantly trip you up (unlike those healthy folks who feel great after a heavy workout).

* Ge HY, et al. Descending pain modulation and its interaction with peripheral sensitization following sustained isometric muscle contraction in fibromyalgia. Eur J Pain 16(2):196-203, 2012. (Available online ahead of print June 28, 2011.)

59 Responses to Keeping Your Body Aches Under Control

  1. Eleanor says:

    Thank you for this very interresting article Living with fibro is an on going thing which I find difficult to accept Your article was helpful
    thank you

    • Robin Clevers says:

      I also found this very interesting, because I experience leg pain after I sit at the computer desk for too long. I ache everywhere if I am in one position too long. This also greatly affects sleeping. Like Eleanor, I am also having trouble accepting that I have fibromyalgia. Right now, I think the fact that I will have this for the rest of my life is the hardest thing to accept. Second is the fact that fibromyalgia is so up and down. One day ‘good’ the next day ‘painful and ill’. Thanks for your site and the up to date info you provide!

  2. Deb says:

    It is difficult to find the balance that does not cause me great pain for days after I exercise. Gentle moderation without over doing it is key!

    • Katie says:

      I try to use physical therapists and chiropractors that regularly treat Fibromyalgia patients… and I ask this question 1st. Exercise is the only thing that breaks the pain cycle for me — getting my heart rate up on the treadmill and doing the gentle stretching exercises that the physical therapist (who treats fibro) has helped. Natural supplements like magnesium and MSM help also.

  3. Tola from Ontario,Canada says:

    Living with fibro and hernated disc L5,is for me is very,very hard and difficult………Your article speaks 100% truth.I have tried Cymbalta lately with terrible side effects, I lost 10 Kgs in 2,5months,my muscles have deteriorated and any activities that I do give me pain.Thank you for this and another very interesting articles. (English is my second language)
    Thank you

    • Jackie says:

      Dear Tola:

      I too have fibro and a herniated disk at L5 and additional others. I have not been able to exercise at all really due to the pain. I am being weaned off of Savella which gave me terrible hot flashes and due to the other pain involved, was not workng. I found that when my back does not hurt, a combination of fiorcet and Ativan works for my fibro. Hope you find some releif soon

    • CuriousMickey says:

      I have Fibro AND a herniated L5, along with a slightly herniated and cysted tailbone… I’ve often wondered how many Fibro patients have spine problems, i.e. herniated discs… “Glad” (in an ironic sense of the term, of course) that I’m not the only one… I honestly wouldn’t wish this upon my worst enemy, at least not for more than a day or so… lol. ;)

    • Patrice Lewis says:

      I also have fibro and a herniated L4-5 disc for which I had a microdiscectomy surgery and which has herniated again since then. I have numerous bulging discs and suffer from many musculoskeletal disorders. I have found aqua therapy and PT to be helpful but only when provided by those knowledgeable in fibromyalgia. it has only helped when started slow and increased very gradually.

  4. Beverly Weatherholtz says:

    Thank you so much, I now understand why exercise is so important.
    This is a really hard disease to live with. Thank you God for everything

  5. Patricia says:

    Can Fibromyalgia cause soreness in a woman’s breasts. I have pain throughout my body constantly, but lately I have noticed an increase in tenderness and soreness in my breasts. I have Mammos and sonograms so I know my breasts are ok as far as anything related to my breasts. Could the Fibro be the reason?

    • Chris says:


      Yes, the Fibro does cause breast tenderness. In my case, I think it is referred pain coming from my neck and back. My fibro developed from having arthritis in my neck, and I have 4 discs fused. Wearing a bra seems to aggravate the trigger points. You might try wearing a sports bra or getting a larger size. I get epidural shots in my back which help for long periods of time, but I’ve been thinking of trying trigger point release therapy because I have so many tender points throughout my whole body. Good luck, and I hope you feel better!

      • lisa says:

        I tried trigger point therapy and trigger point injections and deep message before they realized I had fibro. These therapies increased my pain big time! It wasnt until after I was diagnosed I found out this reaction is common. It took a long time to get those pressure points calmed down again, and beware of well meaning doctors with ” magic thumbs”- misery for ovr 1 yr w 2 spots before I could get his thumbs of steal off 2 of my calmer triggers. Just sayin!

      • Paulette Hill says:

        I have tenderness in My breasts also, I had xrays done and my breasts are fine, I also have a lot of tenderness in my armpits, feels like it’s the glands but I don’t know, I just know it hurts. I can pick up a gallon of milk but the next day I am sore from it.

    • Trudy says:

      Hi the breast pain I saw a specialist for who said patients with Fibro have fibre tissue pain as well as muscles and ligament pain. He prescribed me to take star oil tablets in three times the dose on the bottles. I couldn’t believe the difference the breast pain and tenderness completely went. I stopped taking them as I thought I hadn’t had that pain for few months and within two weeks the pain and tenderness returned so I am still taking them today and touch wood have no breast pain unless I forget them. It did also give slight improvement to all muscle pain and stiffness too. My primary doctor told me to add cod liver oil tablets and vit D and calcium and since then I have reduced my pain killers after 12yrs of being on them. It takes about two to three months to really notice but If you stop taking them that’s when you realise they were helping more than you realised!
      The specialist explained the star oil and evening primrose help balance out hormones too which are indicated as a contributing factor in recent studies so helping them balance improves symptoms but both must be taken in high doses not just the rda levels and they are both totally safe to take Good luck with your pain I hope this helps you as it has me

      • Jen says:

        Hi Trudy (and everyone)
        Thank you for the tip on the Star oil, two Doctors are finally trying to help me with Fibro, not just the other 4 diagnoses I have.

      • CuriousMickey says:

        Hey. What is Star Oil??? I know Evening Primrose, and after reading your comment, I’m going to go back to taking it (what is the dosage you take?)… I’ve never heard of Star Oil, though…???

    • Andrea says:

      I have had Fibro for 26 years. Over this time my FM has got worse. I take up to 400mg of tramadol daily and endone if i am really in a bad way. I injuried my back at work and my wrist and i am not able to work at all because of my pain levels. I hate the fact that my two children and husband have to live with a person with this condition. I walk for 40 minutes a day and i find that this is as far as i can go without causing massive pain. I do boom and bust all the time. When my neck and shoulders hurt I get earache. Everyone out there with FM do not give in to it don’t let it define who you are, try everyday to stay on top of it no matter how hard it gets and believe me i know how bad it can get i was bed ridoned for 6 months when i was 20. Good luck everyone keep battling away.

    • Diane says:

      This was a good article and confirmed what I had already realized for myself.
      In reply to the woman that asked if Fibro causes soar breast tissue, that is true as it affects anywhere there is muscles and nerves.
      I’ve had a lot of success using 100% organic and or wild crafted essential oils as well as products with wild grown Phytoplancton and mushrooms to help my pain.

    • Judy says:

      Do you consume much caffeine ? I was having bad breast pain and my Dr. told me to stop all caffeine–coffee(never drank that anyway) ,tea, cokes ,and chocolate(really hard to give up). But it made a world of difference.I was diagnosed with fibrocystic breast disease. My fibro is worse in my hips, butt and legs.Pain is bad enough, but the exhaustion is miserable.

  6. Jean says:

    This is why I will not go to physical therapy again. I went for a knee problem and told them I had FM, but had me do repetitive knee exercises anyway. They iced my neck and lower back afterwards, but by 20 minutes later, while I was driving home, I hurt everywhere. Even my hands were achy.

  7. Mari says:

    That’s not a very good reason to discard the vast range of options under the PT umbrella. :-( Did you try to work any further with the therapist to adjust the treatment plan, ask for a different therapist or method, or throw the baby out with the bathwater entirely? :-( We tend to forget we’re the ones in charge here: interview and “hire” a therapist the same way you would any other health professional – for instance, say you’ve injured your shoulder. First thing to ask the therapist is “Please tell me your treatment approach for someone with fibromyalgia along with a torn rotator cuff, since I know I’m likely to just quit if I get a flare-up” (which means the injured shoulder also goes untreated, and so overall function drops another little bit…). If the answer doesn’t match up with your research and your needs, give ‘em the boot and on to the next one. I always give a new therapist three sessions, assuming they pass the “interview” – one for the starting-point evaluation and treatment plan, one actual therapy session, and one to assess how they handle my response to the previous session.

    Just like any form of exercise/movement you’re not used to, PT can make you sore as heck (unless it’s one of the modalities that involves very little movement), and the first real session is usually extra rotten because both you and the therapist need to see what you can and can’t do. However, once finding that point is out of the way, the program should be adjusted, and the client should speak up. I’ve been in some kind of PT, both dry-land and aquatic, for years, and when I’m starting a new program or making drastic changes to an existing one, for a while even my HAIR hurts! :-) (I know how long it takes for my pain meds to kick in, so I schedule a dose to coincide with finishing up a session.) Seriously though, I know for certain that I would be back to walkers and wheelchairs and weak as a sick kitten if it weren’t for aquatherapy – both specific therapy programs, like working on my hips, and the Arthritis Foundation class. I’ve driven through blizzards to hit that pool, it helps that much. (Regular swimming doesn’t cut it for me, the movements are too repetitive and I find it just plain boring.) BTW, in addition to the fibro I have five ruptured discs with bone degeneration in the corresponding vertebrae and sacrum (thus sciatica in both legs… talk about a pain in the butt!), widespread osteoarthritis, trashed knees, plantar fasciitis, what I’ve nicknamed “traveling tendinitis” since something’s always going kaput (just finished 8 weeks of specialized PT for tendinitis in both hands – couldn’t even lift a glass of water!), TMJ, and that’s just the orthopedic stuff! :-)

  8. Jean Brown says:

    I found this article enlightening. I had to take my Moms large dog to the vet and he was difficult to handle. Well, the next day my shoulders were in such pain , my legs ached ,from my feet to my hands, even my face hurt. I am also a hairstylist and stand for many hours. This is a recent discovery for me , so any info on how to deal with this health problem is really appreciated. Thankyou

  9. sandra says:

    Thank you for this article. It helps to underrstand what is going onwith me. I was in physical therapy for ten months. I would feel slightly better and thirty minutes later I would be in pain again sometimes worst. Currently I started cvac sessions which I was told takes time to get the full results. What I have noticed is an increase in energy and better sleep. I am hoping this will continue and am looking for a support group in my area. I live in Long Island, NY. If you know of any groups. Thanks

  10. Sherrie says:

    Has anyone heard of spinal cord stimulator implant as a treatment for FM. I have both FM as well as several herniated disc in my neck, thoracic and lumbar spine. My doctor has recommend i have this implaint which will keep the pain single from reaching my brain resulting in pain relief. Not sure how safe it is. If anyone has had this done or knows anything about it, I would appreciate your feedback.

    • Pam says:

      Hi Sherrie
      My neurologist is a headache specialisst who suggested I try and “occipital nerve stimulator”. He was doing clinical trials on them. There were still inherent problems and they were not covered by my insurance so I did not go forward with it. I had heard about the spinal cord stimulator. Is it FDA approved and covered by insurance now? What is the recommending doctor’s specialty and who did he suggest do this implant?
      I am on disability for my fm and been diagnosed in 1985, so I want to be aggressive in trying new modalities.

      I am in the Phoenix. AZ area and want to pursue this.

      • Diane says:

        Hi Pam,
        I am in Gilbert AZ. I wish it was easier to make sure people get replies. I’ve done very well with natural remedies for FM. AIM Transfer Factor for one helped with pain and I lost 25 pounds.

  11. Tanya says:

    I was diagnosed with FM 5 years ago, and I have had to deal with so much confusion, pain, blurred vision, headaches…and the list goes on. The worst part is that I am a nurse. I don’t know for how much longer that I am going to be able to work. I have put on at least 55 pounds in the last 7 years but it is so hard to exercise…it’s a terrible catch 22. I want to exercise but I don’t have the energy to get going and I also know that I am going to be in agony when I am done. I am aware that the exercise is beneficial, it’s just a matter of “how do I manage it”. Most days I feel so useless. My home life has changed dramatically, I don’t have the energy to do anything with my children, and my husband is frustrated with my lack of intrest in our personal life. I am going to try aqua therapy, as well as see what a PT can do for me. Thank you for this article, it gives me hope .

  12. Sheril says:

    Thank you for the article. I had a cramp in the lower right calf. I hollered. Exercise has been essential for me. It is not easy. Yes, at times it can become EXTREMELY painful. As time progresses, I am now able to exercise almost every day. If I do not do some form of movement, FM “acts up” and I become uncomfortable to the “highest” degree. I admit that I do have days when I have to stay in bed for a week or two. Overall, exercise has brought me back to life. Start SLOW, but if you can, s-t-A-R-T. I hope this encourages you.

    God bless eveyone. I feel your pain. I know your tears. I understand “uselessness”.

  13. Shanika says:

    This is crazy. I was just diagnosed with Fibro. But I’ve been saying for years how my legs would hurt as if I over exerted my shoulders. People have been thinking I was crazy and over reacting. WOWWWWW

  14. Jill says:

    Thank you so much for the comment. I have so much pain in my legs there are times when I literally can hardly walk. My MD has been unable to give any satisfactory explaination to this. I hurt almost constantly in my right shoulder – forever doing streches. The article helps me realize once again, it’s not all just in my mind!

  15. Linda says:

    I’ve been saying this for two decades but didn’t know the science behind it. Thank you so much for validation. :)

  16. evie thompson says:

    I have “fibro” (I have friends who dont believe its a real thing) and also degenerative bone disease, heel spurs both heels, plantar fascitis, osteoarthritis knee pain with bone spurs both knees, regular arthritis in neck etc…hypothyroidism which makes me sluggish and these are just things i know are wrong. I lost 165 lbs in 6 yrs and have more to lose, but the pains are intensified and I struggle to get in my workouts now. I’m 47. Still need to lose at least 50 lbs and yes i was wayyyyyyyyyyy up there :(

    • Kristin says:

      Evie, luckily for you, many of us DO believe and understand your pain and discomfort. Congrats on your inspiring weight loss. Keep up the GREAT work. Best of Luck.

    • Clark Bales says:

      I hate this disease and don’t let anyone tell you, especially MD’s that FM is a wastebasket diagnoses. I’ve been stuck down right before a huge promotion and a hefty salary increase. 12 years later I can’t play ball with my grand son. Can’t even throw a baseball. I was a pitcher in my youth, it’s tough not being able to coach my grand children. Just one thing fibro has taken. It’s EVIL!

  17. Gloria says:

    That makes total sense to me! My legs are painful every time I try to do anything using my upper body, ie shoulders and neck. I’m currently getting Biofeedback for my Fibro and it is starting to give me some help. I had tried everything else and was bedridden most of the time, but now I’m able to be more active. Thank you for this great article. Be well everybody.

    • Mag says:

      Thanks! Yeah, the cause of the pain makes a big denfirefce. So does the consistency that kind of mobile pain you’re talking about suuuuuucks. That’s interesting about exhaustion! I haven’t spent as much time thinking about exhaustion, although I experience it enough you’d think I would have.

  18. Phyllis says:

    I too have extreme leg, ankle and heel pain. I am trying to lose some weight and have basically given up trying exercise.
    As far as having PT, Medicare only allows so many sessions, etc., so I don’t even try anymore. With the so called “health care reform”, the only winners are the insurance companies who have made certain their profits continue at the expense of the people they insure.
    I find that hydrotherapy does wonders for me, but the whirlpools at the park where I live are obviously used by others and sometimes I get an infection or develop a rash after use in spite of rushing home for a shower.
    I have an order from my doctor for my own hydrotherapy tub or spa, but that presents a whole host of other, expensive issues in order to get and install one.
    In the meantime, I continue to try to live my life, work – I have to use a computer daily – and deal with the insomnia, the pain and all of the rest.
    Thank you Kristin for your easy to read, informative articles that at least let me know I’m not alone and not necessarily crazy.

  19. jan kane says:

    Sherrie…to answer about a spinal cord stim (SCS). I have had one for a little over a year. Back pain had been a central part of my FM for many years. Prior to diag for qualifications some docs were very willing to do back surgery. FM took my career as an operating rm. RN and I wasn’t going in that direction. It has helped greatly and esp. with nerve damage from several foot surgeries (which I think stemmed from the back). Leads from the SCS can be directed into many areas. Just choose the manufacture with a very small battery. I had to endure a battery change due to my doc not going over all the info with me. I researched the manufacture site and didn’t realize I was not getting full info there. Main info: I would not like to do without. (On occasion, I will turn it off for a few hours. There is some relief in that. Don’t know why. But do like that factor.) Research, research, research…docs and manufacturers!!!

    • Serhat says:

      YES! Thank you so much for witring this. That migraine commercial makes me want to set fire to the TV. Women are people, not meat bags here to provide for everyone else’s needs.

  20. JB says:

    Mari, I love your term “travelling tendonitis” it describes me perfectly. I’m going to take liberties with it.

  21. Cheryl says:

    I have constant neck and shoulder pain. I had a job that I was on my feet for a solid eight hours. Now when I stand I get numbness in the top part of my legs. Wondering if all this has to do with my fibromyalgia

  22. EILENE RATLIFF says:

    Thanks for this information. I have noticed that my legs kill me when trying to sleep. Yes it could be Restless Leg, but I take medication for that and it doesn’t help. The Fibro pain that i have been having is just about to drive me crazy. I have suffering with Fibro for about 15 yrs. I can tell that the pain is getting worse the older I get. I had to leave work in 2007. It was a very streessful job. I try to keep stress out of my life but that is impossible to do, but i do trust in GOD to help me thru each day.

    • Rachel Escamilla says:

      Aah yes restless legs syndrome (RLS). At this moment I am feeling tingles in my calves. Very irritating. I am clothes sensitive. Can’t wear jeans, top leg pain. Can’t wear any kind of clothes that even touch my calves. Bras, heck no. Ahh Bra works. I get burning and pain.

    • C M says:

      I have had Fibro for yrs and I too am having terrible leg pain during the night-NOT RLS-to the point of it constantly waking me up and then not being able to get back to sleep. None of the RX I have been given helps. I did find that a cholesterol RX I was taking made the leg pain much worse, so am off that now. I have recently read about the zinc, magnesium, & melatonin combo for sleep help in another post on this site. I have not tried that yet, but am going to start now.

  23. JoAnne says:

    I have found warm water PT pretty beneficial…Less post exercise pain than conventional.

  24. Ruth says:

    Thank-you so much for this article. I could never figure out why being on my feet all day also caused severe pain in my shoulders, arms and wrists.

  25. Kathi says:

    How interesting! My fibro has always been the worst in my hips/buttocks/thighs. I was recently in a car accident where I got whiplash. I was in PT for 8 weeks and the pain in my legs was significant.

  26. Kristin says:

    I truly enjoyed this article and all of the wonderful discussion that followed. Thank you so much for sharing : )

  27. Angela says:

    I have suffered with fibro for over a year now. I have found that doing light stretching and yoga helps, but somedays my body just hurt so much that I cant even bring myself to do that. I have tried almost all of the medications they prescribe for this, and have had no luck with none of them. I am currently looking for all natural stuff to try. I hope I find something soon. I am not a depressed person at all, but feel that my fibro flare could very easily make me very depressed.. :/
    Love the article..

  28. June Codding says:

    Have ha d fibro for at least 20 years, md’s always said it was in my mind. ha. Was told that surgery on the stenosis could make things worse instead of better. It has helped the shoulder surgery but the left shoulder is acting up now. My therapist was pushing the exercise too much and I would suffer for 2 days afterwards. Now that he has been stressing less things are better but the pain sometimes almost unbearable even with pain meds. One md kept decreasing them, told me if i didn’t like it go find another md –so i did . I can’t sleep in a bed, sleep in my recliner. Would love to find out something that would work. Have problems with a lot of medications. i am a senior citizen – 79- but still want to be as active as possible. Am frustrated.

  29. Elaine Ratcliffe says:

    I have recently gone through a 2 week Fibro ‘flare’…back spasm & chronic pain in hips, knees, feet (plus Plantar Fascillitis) Unable to walk during most of those days, but thankfully things are calming down again. I know this is only for a short time, but thank goodness we do get even short periods out of this dreadful ‘black hole’ of pain sometimes. Healing thoughts to you all xx

  30. Carolyn says:

    Elaine: Everyone else’s replies are all from earlier times since this article is a reprint from another time but apparently you and I hadn’t read it before. I love what you said about being thankful for even the short periods we have out of the “black hole” of pain. It always helps me to remember that , this too shall pass when I have a flare. It is so hard to explain this pain to others…

  31. julie says:

    What was the chloresteral medicine that was discontinued and helped some pain. ?

  32. Kem says:

    I hope someone can answer my previous post question. I feel like almost each time I have seen a Dr, I need to go to the ER a few days after with extreme symptoms. I go days trying to recuperate from what they have done to me. Thank You
    I was always an active person for years and all of this has been difficult to deal with emotionally and physically.

  33. Donna says:

    Thanks for the article. I used the computer extensively for the past three years for my online Masters in Business Administration. The shoulder, neck and arm pain got worse over time. Recently I noticed that my legs and hips were giving me a hard time in the mornings and I couldn’t walk properly. I’m doing a.m. leg stretching exercises now before getting out of bed. That’s helped a lot.

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