Fibromyalgia is a chronic condition that causes widespread pain and tenderness throughout the body. While fibromyalgia is often associated with pain in the muscles and joints, many people with fibromyalgia also experience symptoms in their legs and feet.
What is fibromyalgia?
Fibromyalgia is classified as a rheumatic condition because it causes soft tissue pain and tenderness in the muscles, ligaments, and tendons. However, unlike many rheumatic diseases, fibromyalgia does not cause inflammation or damage to the joints or tissues.
Instead, researchers believe fibromyalgia is caused by abnormalities in how the brain and spinal cord process pain signals. It appears to be related to changes in certain neurotransmitters or chemical messengers that transport signals between nerve cells.
In people with fibromyalgia, the threshold for feeling pain is lowered so that sensations that would not be painful to healthy individuals feels very painful to those with fibromyalgia. Researchers have also found that people with fibromyalgia have more nerve fibers that transmit pain signals.
The most common symptoms of fibromyalgia include:
- Chronic widespread pain
- Increased sensitivity to pain (hyperalgesia)
- Muscle stiffness
- Fatigue
- Problems sleeping
- Difficulty concentrating or “fibro fog”
- Headaches and migraines
- Numbness or tingling
- Irritable bowel syndrome
- Pelvic pain or pain during intercourse
Fibromyalgia pain often waxes and wanes over time. Flare ups can be triggered by emotional stress, physical overexertion, weather changes, and lack of sleep. During a flare up, pain and other symptoms are often worse.
How might fibromyalgia affect the legs?
Many people with fibromyalgia experience muscle aches and pains in their legs. The thighs, calves, and hips are common sites of discomfort.
Some specific leg symptoms that can occur with fibromyalgia include:
- Muscle cramps, spasms, stiffness, and tightness
- Sharp, shooting pains or throbbing aches
- “Pins and needles” sensations
- Restless leg syndrome
- Feeling of heaviness or weakness in the legs
The constant leg pain and muscle tightness can make it difficult to stand, walk, or climb stairs. Sitting for a long time may also aggravate leg discomfort.
What causes leg pain with fibromyalgia?
Doctors are not entirely sure why fibromyalgia causes leg pain, but some theories include:
- Increased sensitivity of pain receptors in the muscles
- Reduced blood flow to the muscles
- Abnormalities in neurotransmitter levels
- Metabolic changes that cause build up of pain-promoting substances
Research does show that people with fibromyalgia often have lower levels of serotonin, norepinephrine, and dopamine. These neurotransmitters inhibit pain signals in the brain. Low levels result in increased pain perception.
Studies using magnetic resonance spectroscopy also show that fibromyalgia patients have higher levels of choline, glutamate, and lactate in their leg muscles. These substances are involved in pain signaling pathways.
How might fibromyalgia affect the feet?
Many people with fibromyalgia also have chronic pain and tenderness in their feet. Common foot symptoms include:
- Burning, tingling, numbness
- Shooting pain, feeling like you’re walking on pebbles
- Pain that moves from the heel to the toe
- Arch pain or soreness
- Feet feel cold despite normal temperature
- Sensation that socks or shoes are too tight
The discomfort may affect the entire foot or be focused in areas like the heels, balls of the feet, or toes. Many fibromyalgia patients experience plantar fasciitis, an inflammation of the tissue along the bottom of the foot that connects the heel bone to the toes.
What causes fibromyalgia foot pain?
Researchers believe foot pain occurs for similar reasons as the leg pain – abnormalities in pain processing pathways. Contributing factors likely include:
- Increased sensitivity of pain receptors in the feet
- Chronic inflammation
- Decreased blood flow
- Muscle spasms
- Nerve compression or irritation
The constant muscle tension and stiffness in fibromyalgia puts extra stress on the feet. This can aggravate conditions like plantar fasciitis. Researchers have also found people with fibromyalgia have reduced fat padding on the bottom of their feet, making them more prone to pain.
How is leg and foot pain diagnosed?
There are no lab tests that can diagnose fibromyalgia. Doctors make the diagnosis based on a clinical examination and evaluation of your symptoms. They will typically check certain “tender points” throughout the body that are often painful in fibromyalgia patients when pressed.
To be diagnosed with fibromyalgia, you must have had widespread pain for at least 3 months and test positive for tenderness in at least 11 of 18 specific tender point sites.
Your doctor will also conduct tests to rule out other conditions that could be causing your pain, such as rheumatoid arthritis, lupus, or thyroid disorders. A physical exam can check for signs of arthritis, nerve damage, or muscle injury that could be contributing to leg and foot discomfort.
How is leg and foot pain in fibromyalgia treated?
While there is no cure for fibromyalgia, there are many treatments that can help reduce muscle aches, pains, and tenderness. Possible treatment options for leg and foot discomfort include:
Medications
Prescription medications that may help include:
- Pain relievers like tramadol or duloxetine
- Antidepressants like milnacipran, amitriptyline, or cymbalta
- Anti-seizure drugs such as pregabalin
- Muscle relaxants like cyclobenzaprine
- Over-the-counter pain medicines like acetaminophen, ibuprofen, or naproxen
Exercise and stretching
Low-impact exercises like walking, swimming, or cycling can help reduce muscle tightness and improve flexibility. Stretches that target the muscles in the legs and feet may also provide pain relief.
Massage
Massaging sore muscles can help improve blood flow and reduce muscle spasms and pain. Self-massage, professional massage therapy, or trigger point treatments may provide leg and foot pain relief.
Physical therapy
Working with a physical therapist can help identify exercises or mobility aids that reduce strain on painful muscles and joints.
Orthotics
Inserts or supportive shoes designed to improve foot alignment and support the arches may help reduce foot discomfort.
Cold and heat
Alternating cold packs and heat therapy may help soothe aching muscles and sore feet.
Rest and sleep
Getting adequate rest and treating sleep disorders can help minimize fibromyalgia pain and flare ups.
Stress reduction
Techniques like meditation, yoga, tai chi, or cognitive behavioral therapy can help control stress and anxiety, reducing fibromyalgia symptoms.
When to see a doctor
See your doctor promptly if you experience sudden, severe, or worsening leg or foot pain. Seek emergency care for pain accompanied by:
- Numbness or weakness
- Changes in bowel or bladder function
- Unexplained weight loss
- Swelling in the legs
- Injury to the leg or foot
These symptoms could indicate an underlying medical condition that requires urgent treatment, like a nerve compression disorder or blood clot.
Also talk to your doctor if over-the-counter medications and home remedies are not improving your pain. Other therapies or prescription medication may provide more effective relief.
How to cope with leg and foot pain from fibromyalgia
Living with constant muscle aches and discomfort can be challenging. Here are some tips for coping with leg and foot pain from fibromyalgia:
- Listen to your body – avoid overdoing activities that aggravate pain
- Apply ice or heat to painful areas
- Soak in warm Epsom salt baths
- Get massages and stretch regularly
- Ask for help with household chores if needed
- Use mobility aids if walking is difficult
- Rest when fatigue sets in
- Join a fibromyalgia support group
- Communicate with loved ones about your limitations
- Stay positive and know there are treatment options to explore
Can leg and foot pain be prevented?
There is no known way to prevent fibromyalgia or the leg and foot pain it causes. However, the following healthy lifestyle habits may help minimize flare-ups:
- Get regular exercise appropriate for your fitness level
- Maintain a healthy diet and weight
- Reduce stress through relaxation techniques
- Get sufficient sleep and treat any sleep disorders
- Avoid repetitive motions that strain the legs and feet
- Wear supportive shoes with cushioning
- Stretch before and after exercising
The takeaway
Leg and foot pain are common symptoms for many people living with fibromyalgia. The widespread muscle tenderness and increased pain sensitivity associated with this condition can affect the lower extremities.
There are many possible fibromyalgia treatment options available that may help reduce leg and foot discomfort. See your doctor promptly if pain becomes severe or is accompanied by other symptoms like numbness or swelling. While fibromyalgia is a chronic condition, many people are able to manage their symptoms and improve their quality of life.
