Fibromyalgia is a chronic condition defined by widespread musculoskeletal pain, often accompanied by fatigue, sleep disturbances, and cognitive difficulties. Tinnitus is the perception of sound, such as ringing, buzzing, or roaring, when no external sound is present. Although these conditions affect different systems—musculoskeletal and auditory—they frequently occur together. This common overlap suggests a link pointing toward a shared underlying biological mechanism.
The Connection Between Fibromyalgia and Tinnitus
Studies consistently show a statistically significant relationship between a fibromyalgia diagnosis and the presence of tinnitus. The prevalence of tinnitus in the general population is typically cited between 10% and 17%. However, in groups of patients diagnosed with fibromyalgia, this rate dramatically increases, often reported in studies to be between 59% and 74.3%. This stark contrast indicates that an individual with fibromyalgia is several times more likely to experience persistent ringing or buzzing in their ears compared to a healthy person.
The severity of the auditory symptoms also tends to mirror the overall impact of the chronic pain disorder. Research has found a positive correlation between higher scores on the Tinnitus Handicap Inventory (THI) and increased scores on the Revised Fibromyalgia Impact Questionnaire (FIQR). This suggests that as the patient’s fibromyalgia symptoms worsen, the burden of their tinnitus often increases simultaneously. The tinnitus associated with fibromyalgia is typically a continuous, bilateral sound, and it frequently involves a heightened sensitivity to everyday noises, known as hyperacusis.
Shared Neurological Mechanisms
The underlying connection between these two seemingly disparate conditions is attributed to a dysfunction in the central nervous system known as central sensitization (CS). Central sensitization is the core mechanism of fibromyalgia, involving the chronic over-amplification of sensory signals by the brain and spinal cord. This process leads to an exaggerated response to stimuli that would normally not be painful, or in this case, would not cause auditory distress.
In this state of heightened sensitivity, the brain’s pain matrix becomes perpetually activated and hyper-responsive. The same central nervous system structures responsible for processing pain signals also interact with auditory pathways. When the central nervous system is in a state of CS, it essentially turns up the volume on all sensory input, which can manifest as both widespread pain and the non-existent sound perception of tinnitus.
Dysregulation of certain neurotransmitters, the brain’s chemical messengers, further supports this theory. For example, increased levels of the excitatory neurotransmitter glutamate have been observed in specific brain regions of fibromyalgia patients. This neurochemical imbalance contributes to the overall hyperexcitability of the central nervous system, affecting not only the processing of chronic pain but also the perception of sound.
Targeted Management of Tinnitus in Fibromyalgia Patients
A successful strategy for managing tinnitus in a fibromyalgia patient often involves addressing the underlying central sensitization that drives both conditions. Treatment for fibromyalgia itself, particularly with centrally acting medications, has been shown to reduce the severity of coexisting tinnitus. For instance, drugs like Pregabalin and certain serotonin-norepinephrine reuptake inhibitors (SNRIs), such as Duloxetine, which are routinely used for fibromyalgia, have demonstrated a significant ability to decrease tinnitus levels in these patients.
Non-pharmacological approaches are also effective in helping the brain habituate to the phantom noise. Sound therapy, which includes the use of white noise or other low-level background sounds, can help mask the tinnitus and retrain the brain to ignore the sound over time. Cognitive Behavioral Therapy (CBT) is beneficial because it helps patients change their emotional reaction to the tinnitus, thereby reducing the distress and perceived loudness.
It is important to rule out other potential causes, such as temporomandibular joint (TMJ) dysfunction, specific ear conditions, or medication side effects. Stress reduction techniques, like mindful movement and meditation, are also commonly employed, as stress is known to exacerbate both chronic pain and the perception of tinnitus. A comprehensive approach that targets the neurological overlap is necessary to effectively alleviate both the chronic pain and the auditory symptoms.