Understanding the Relationship Between Sciatica and Fibromyalgia

Chronic pain conditions like sciatica and fibromyalgia share some similar symptoms but also have key differences.

These two are more connected than you may realize. These misunderstood syndromes manifest in similar ways and share underlying causes, yet are often treated separately. Unpacking the intersection between sciatica and fibromyalgia sheds light on more holistic and integrated treatment methods.

In this guide from our experts at Kaly, we’ll provide an in-depth look at how to identify each condition and manage pain associated with both.

What is Sciatica?

Sciatica refers to radiating pain stemming from irritation or compression of the sciatic nerve, which runs from the lower back down each leg. Sciatic nerve pain varies from intermittent shooting, burning or throbbing sensations to numbness or muscle weakness in the back, buttocks, and legs. Sciatica triggers include spinal disc herniations, bone spurs, pregnancy, injury, and spinal stenosis.

Sciatica is typically diagnosed through medical history, physical examination, x-rays, MRIs, and CT scans. Treatments range from hot/cold therapy and gentle stretches to pain medication, steroid injections, acupuncture, and sometimes surgery for severe cases.

Defining Fibromyalgia

Whereas sciatica targets specific areas, fibromyalgia manifests as widespread muscular and joint pain plus mood issues. Other fibromyalgia symptoms include poor sleep, headaches, memory problems, tingling/numbness, and extreme fatigue.

Symptom	Sciatica	Fibromyalgia
Pain Location	Lower back, buttocks, legs	Widespread
Pain Type	Shooting, burning, throbbing	Aching, throbbing
Other Symptoms	Numbness, tingling	Fatigue, “brain fog”, memory issues

While fibromyalgia’s causes remain unclear, possible origins involve genetics, hormonal shifts, and abnormalities in pain signal processing. Trauma and repetitive nerve stimulation may also play a role. 

There is no definitive lab test for fibromyalgia, so diagnosis relies on tracking locations of pain over time.

The Connection Between Sciatica and Fibromyalgia

Research reveals meaningful links between sciatica and fibromyalgia:

• A lot of fibromyalgia patients also experience sciatica, and vice versa. Both involve neuropathic nerve discomfort.
• Central sensitization, referring to overactive pain signals in the brain and spinal cord, may contribute to both conditions.
• Muscle tension from sciatica may worsen fibromyalgia body aches. The reverse holds true too.
• Sciatica can trigger fibromyalgia flares, as pain often snowballs. Sleep disruption from nighttime sciatica and leg spasms plays a role.

In essence, these complex pain syndromes exacerbate each other through interconnected neurological and musculoskeletal pathways. Treating them in tandem is paramount.

Distinguishing Sciatica vs. Fibromyalgia Pain

The nature of the pain differs substantially between sciatica and fibromyalgia. Here are some key ways to tell them apart:

• Sciatic pain radiates along the path of the sciatic nerve, following its branches down your leg in a very specific pattern. Fibromyalgia pain is more generalized and felt all over.
• Sciatica pain is often described as sharp, shooting pain or electric shocks. Fibromyalgia pain is usually more dull, stiff, and aching.
• Sciatic pain may be provoked by certain movements like coughing, sneezing or sitting for extended periods. Fibromyalgia pain is more constant and not triggered by specific actions.
• Sciatica pain is unilateral, occurring on just one side of your body. Fibromyalgia pain is generally bilateral, felt on both sides.
• Sciatica often causes numbness or weakness in parts of the leg. Fibromyalgia does not directly result in weakness or numbness.

Paying attention to these subtle differences can help you identify whether your pain stems from sciatic nerve irritation or fibromyalgia. Keeping a pain journal where you track symptoms day-to-day can be invaluable for noticing patterns.

How Fibromyalgia Can Lead to Nerve Pain

While fibromyalgia itself doesn’t directly compress or damage nerves, it can contribute to nerve pain in a few indirect ways:

• Increased Sensitivity – People with fibromyalgia have enhanced pain sensitivity due to overactive nervous system responses. This can cause non-painful stimuli to be experienced as very painful.
• Central Sensitization – Fibromyalgia is associated with changes in how the central nervous system processes pain signals, essentially amplifying them. This can make existing or minor nerve irritation much more painful.
• Muscle Tension – The musculoskeletal pain and tightness from fibromyalgia can lead to pinched nerves or irritation of nerve branches associated with trigger points and tender points.
• Postural Changes – Some people with fibromyalgia adjust or limit their movements to avoid pain, which can put strain on nerves. Hunching of shoulders, for example, can compress the brachial plexus nerves.
• Underlying Conditions – Autoimmune or endocrine disorders associated with fibromyalgia, like lupus or hypothyroidism, can also contribute to neuropathic pain or nerve damage.

While fibromyalgia itself does not directly injure nerves, it creates an environment where nerves are more easily aggravated and less able to tolerate any inflammation or irritation. This results in enhanced nerve pain symptoms.

Can Fibromyalgia Mimic Symptoms of Sciatica?

Fibromyalgia cannot cause true sciatica, since it does not damage or compress the sciatic nerve itself. However, it can sometimes produce pain that radiates down the legs and mimics sciatic pain.

Referred pain and trigger points are two ways fibromyalgia can imitate sciatica symptoms:

• Referred Pain – Fibromyalgia pain signals from the lower back can be misinterpreted by the brain as coming from the leg, causing pain to be felt along the sciatic nerve pathway. But there is no actual nerve irritation.
• Trigger Points – Hyperirritable knots in muscle tissue can refer pain to other areas. Trigger points in the piriformis muscle in the buttocks often refer to pain down the leg, resembling sciatica. But again, this is not true sciatic nerve pain.

The quality and nature of the pain differs in these fibromyalgia-related symptoms compared to classic sciatica. But it can sometimes be difficult, even for doctors, to discern whether radiating leg pain is caused by true sciatica or fibromyalgia referral patterns. 

Can Fibromyalgia Make Sciatica Worse?

Absolutely. For those suffering from both conditions, research indicates that fibromyalgia can amplify and exacerbate the pain associated with sciatica in several important ways:

• Increased intensity – Sensitization of the central nervous system due to fibromyalgia lowers the pain threshold, making sciatica pain feel more intense.
• Greater duration – Fibromyalgia-related muscle tension and poor posture can place sustained pressure on the sciatic nerve, prolonging recovery time.
• Expanded pain areas – Referred pain from fibromyalgia trigger points can expand pain to areas beyond the sciatic nerve, like the feet or upper legs.
• Decreased activity tolerance – The fatigue and deconditioning associated with fibromyalgia limits the ability to participate in rehabilitative exercise for sciatica.
• Poor sleep quality – Lack of restorative sleep from fibromyalgia prevents the body from recovering well between sciatica flare-ups.
• Emotional distress – Coping with constant fibromyalgia pain increases anxiety, depression, and stress levels, compounding the challenge of managing sciatica.
• Medication effects – Medications used for fibromyalgia, like gabapentin or NSAIDs, can sometimes aggravate sciatica symptoms.

In essence, the neurological and systemic effects of fibromyalgia create the “perfect storm” to enhance and prolong any pre-existing nerve pain from sciatica. 

Treating Co-Occurring Sciatica and Fibromyalgia

If you suffer from both sciatica and fibromyalgia, an integrative treatment approach can help provide pain relief. Some of the most effective treatment strategies include:

Treatment Strategy	Description	Benefits for Sciatica	Benefits for Fibromyalgia
Medications	Anti-inflammatories, analgesics, antidepressants, and anticonvulsants.	Helps relieve neuropathic pain.	Aids in managing overall pain levels.
Pain Psychology	Cognitive behavioral therapy and mindfulness training.	Changes pain perception.	Improves coping abilities.
Exercise Therapy	Gentle exercises like pilates, yoga, swimming, and walking.	Improves strength and mobility, reduces nerve pressure.	Alleviates symptoms without aggravation.
Massage	Therapeutic massage and trigger point therapy.	Relieves muscle tightness and spasms.	Addresses referred pain patterns.
Physical Therapy	Stretching, postural correction, heat/cold therapies.	Relaxes muscles, takes pressure off the sciatic nerve.	Helps in muscle relaxation and posture improvement.
Lifestyle Modifications	Improving sleep, managing stress, healthy weight, quitting smoking.	Supports overall well-being and reduces pain triggers.	Essential for overall health management and symptom reduction.

While fibromyalgia and sciatica respond best to some differing interventions, many nonsurgical treatment options offer dual benefits. A combination approach tailored to your specific circumstances provides the best chance at experienced relief.

Live Pain-Free With Kaly

Living with both fibromyalgia and sciatica presents unique challenges. But gaining a better understanding of each condition and how they interact is the first step on your path to taking back control and living a full life.

At Kaly, we know living with chronic pain can be quite an ordeal. But our goal is to empower you with the tools and support you need to live a fulfilling life. Join us and discover scientifically-backed solutions for managing your sciatica and fibromyalgia. The pain relief you’ve been waiting for is within reach.