Fibromyalgia is a chronic condition defined by widespread musculoskeletal pain accompanied by fatigue, sleep disturbances, and cognitive difficulties. This complex syndrome involves a variety of sensory symptoms that can fluctuate dramatically. People living with this disorder frequently report sensations that go beyond simple pain, often describing unusual feelings in their limbs or face. This article explores the connection between fibromyalgia and sensations of numbness and tingling, explaining the underlying neurological mechanisms and outlining when these symptoms warrant medical attention.
Paresthesia as a Common Fibromyalgia Symptom
Numbness and tingling, medically termed paresthesia, are highly common complaints among those diagnosed with fibromyalgia. These sensations are often described as a feeling of “pins and needles,” crawling, burning, or a partial loss of sensation. Studies indicate that a large percentage of fibromyalgia patients experience these neurological symptoms at some point.
The presentation of this numbness is often distinct from that caused by a simple compressed nerve. Fibromyalgia-related paresthesia tends to be bilateral, affecting both sides of the body simultaneously, and may move unpredictably around the arms, hands, legs, and feet. Unlike conditions such as carpal tunnel syndrome, the numbness does not strictly follow the path of a single major nerve. These sensations can come and go, changing in intensity and location without an apparent physical trigger.
Understanding Nerve Signal Processing in Fibromyalgia
The reason for these confusing sensations lies in changes to how the central nervous system processes signals from the body. A primary mechanism contributing to the widespread symptoms of fibromyalgia is called Central Sensitization. This process involves the brain and spinal cord becoming hypersensitive, effectively amplifying normal sensory input.
In this state, non-painful touch, pressure, or temperature signals are misinterpreted, leading the brain to perceive them as pain or an abnormal sensation like tingling or numbness. The central nervous system develops a persistent, heightened state of excitability. This heightened excitability results in a lower threshold for sensory signals, thereby generating the feeling of pins and needles.
Adding to the complexity, a significant subgroup of people with fibromyalgia also show objective evidence of Small Fiber Neuropathy (SFN). SFN involves damage or loss of the small nerve endings in the skin that transmit pain, temperature, and some sensory signals. Research suggests that approximately 40 to 70% of fibromyalgia patients may have this small nerve pathology. The presence of SFN provides a peripheral explanation for some of the burning, numbness, and tingling experienced by these individuals.
When Numbness Requires Medical Evaluation
While non-specific numbness and tingling are common with fibromyalgia, the symptom itself can signal other, potentially severe, medical issues. Healthcare providers must rule out mechanical nerve compressions, such as sciatica or carpal tunnel syndrome, which can co-exist with fibromyalgia and require different treatments. Conditions like peripheral neuropathy caused by diabetes or certain vitamin deficiencies can also present with similar symptoms, making a thorough medical workup important.
There are specific “red flag” symptoms that indicate the numbness is likely not typical fibromyalgia-related paresthesia and requires immediate medical attention. Any sudden onset of numbness, especially if confined to one side of the body, should be evaluated urgently. This unilateral numbness, particularly when accompanied by facial drooping, slurred speech, or sudden confusion, can be a sign of a stroke.
Additionally, progressive weakness, difficulty walking, or a loss of balance that coincides with the numbness warrants immediate consultation. A loss of bladder or bowel control alongside new or worsening numbness in the legs or groin is another serious warning sign that requires emergency evaluation. While fibromyalgia symptoms are typically chronic and fluctuating, any abrupt, severe, or rapidly progressing change in sensation should be taken seriously to rule out other neurological or vascular emergencies.