Fibromyalgia (FM) is a long-term health condition characterized by chronic, widespread pain and tenderness affecting the musculoskeletal system. This systemic disorder often includes fatigue, sleep disturbances, and cognitive difficulties. Many individuals with FM experience throat-related symptoms, suggesting the disorder’s systemic effects can influence the delicate muscles responsible for speaking and swallowing. This article explores the underlying mechanisms and resulting symptoms connecting widespread FM pain to difficulties and sensations in the throat area.
How Fibromyalgia Affects Neck and Throat Muscles
The primary physiological mechanism linking fibromyalgia to pain in the throat area is a phenomenon known as central sensitization. This process involves an amplification of pain signals within the central nervous system, causing the brain and spinal cord to become hypersensitive to stimuli that should not normally be painful. This heightened sensitivity lowers the pain threshold across the entire body, including muscles in the head and neck.
The muscles of the neck and shoulders are common sites for localized pain and tenderness in FM patients. This sensitivity often manifests as myofascial trigger points in muscles like the sternocleidomastoid and other associated muscles around the pharynx. The chronic muscle tension resulting from amplified pain signaling can directly impact the functionality of nearby throat structures.
When the muscles supporting the throat and jaw are perpetually tense or painful, their coordinated movements become impaired. This tension can lead to chronic muscle fatigue, a frequent symptom in FM, that affects the muscles used for speech and swallowing. Therefore, the widespread pain disorder creates a local environment of hyper-irritability and dysfunction in the throat musculature.
Experiencing Swallowing Difficulties and Throat Sensations
The direct involvement of throat muscles leads to a range of specific symptoms. One of the most significant is dysphagia, or difficulty swallowing, reported to be prevalent in over 50% of FM patients in some studies. This often presents as oropharyngeal dysphagia, where the patient has trouble initiating the swallow or feels like food is getting stuck high in the throat.
A common and distressing symptom is the “globus sensation,” or globus pharyngeus. This is the persistent feeling of a lump, tightness, or foreign object in the throat when no physical obstruction is present. This sensation is likely due to unceasing spasm and tension in the muscles of the pharynx and upper esophageal sphincter, which react to amplified pain signals.
Beyond swallowing issues, patients may experience persistent throat clearing, a chronic sore throat (odynophagia), or voice changes (dysphonia). The muscle tension can affect the larynx, leading to muscle tension dysphonia, resulting in a hoarse or strained voice quality. These symptoms are often interconnected, stemming from constant muscle fatigue and tension caused by the central pain process.
Clinical Diagnosis and Management Strategies
When a patient with fibromyalgia presents with throat symptoms, a thorough differential diagnosis is required to rule out other causes. Conditions like gastroesophageal reflux disease (GERD), structural abnormalities, or anxiety-related muscle tension can mimic these symptoms and often co-occur with FM. Clinicians must use objective diagnostic tests, such as flexible fiberoptic endoscopic evaluation of swallowing (FEES) or ultrasonography, to confirm the swallowing issue and ensure no serious pathology is overlooked.
Management of FM-related throat issues often requires a multidisciplinary approach focused on addressing both the central pain amplification and the local muscle dysfunction. For targeted swallowing difficulties, a consultation with a speech-language pathologist (SLP) is appropriate. The SLP can provide specific swallowing exercises and techniques to improve the strength and coordination of the oral and pharyngeal muscles.
Localized muscle relaxation techniques, such as physical therapy or myofascial release, can help alleviate tension in the neck and throat muscles. Adjusting central pain medications is also important, as drugs targeting the central nervous system (like certain antidepressants or anticonvulsants) can dampen the nerve hypersensitivity driving muscle tension. Treatment plans must be carefully balanced, as some FM medications can cause side effects like dry mouth, which worsens swallowing.