Understanding Fibromyalgia and Upper Back Pain

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Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, fatigue and mood disturbances

For many people with fibromyalgia, upper back pain is a common and disabling symptom that can greatly impact quality of life. 

This article provides an overview of fibromyalgia and its association with upper back pain, as well as management strategies to reduce symptoms and improve function.

Fibromyalgia Explained

Fibromyalgia causes pain throughout the body, especially in the muscles and joints. It often produces stiffness and tenderness in the neck, shoulders and upper back. 

Other symptoms include sleep disturbances, difficulty thinking or remembering things (brain fog), headache and mood changes like anxiety or depression.

While the exact cause of fibromyalgia is unknown, research suggests abnormalities in central nervous system processes involved in pain perception and regulation. 

This may lead to a heightened and prolonged response to pain in the brain and spinal cord, resulting in chronic widespread pain and sensitivity.

Upper back pain is a common manifestation of fibromyalgia, occurring in up to 86% of patients. The upper back muscles often become stiff, tender and prone to trigger points that can cause acute flares of severe pain. 

Over time, this constant strain may lead to deterioration of muscles and soft tissues in the upper back.

Fatigue and poor sleep, two hallmark symptoms of fibromyalgia, also contribute to upper back pain by increasing muscle tension and inhibiting recovery processes. When left untreated, fibromyalgia-related upper back pain can worsen over time and limit mobility and function.

To improve outcomes, an integrated approach is needed that addresses both fibromyalgia as a whole and specific issues related to upper back pain. Medications, exercise therapy, cognitive behavioral therapy and adaptive devices/strategies can all play a role in management.

Understanding Fibromyalgia

Fibromyalgia is a chronic rheumatic condition characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive dysfunction. 

It often occurs together with other medical conditions like chronic fatigue syndrome, irritable bowel syndrome, restless leg syndrome and tension headaches.

Symptoms of fibromyalgia include:

  • Chronic full-body pain that tends to be more severe in muscles and joints, including the upper back
  • Fatigue that interferes with daily functioning
  • Nonrestorative sleep and frequent insomnia
  • “Fibro-fog": Difficulty with memory, concentration, and thinking clearly
  • Morning stiffness
  • Mood changes like depression and anxiety
  • Tenderness in at least 11 of 18 specific points when pressure is applied

The causes of fibromyalgia are still unclear but likely involve a combination of genetic and environmental factors. Some research suggests abnormalities in the way the central nervous system processes pain sensations in fibromyalgia patients.

While there is no cure for fibromyalgia, treatments aim to reduce symptoms and improve quality of life. A tailored treatment plan may include:

  • Medications to manage pain, sleep disturbances and mood symptoms
  • Physical therapy focused on exercises to improve strength, flexibility and range of motion
  • Cognitive behavioral therapy to help cope with chronic stress and pain
  • Lifestyle modifications like a balanced diet, adequate sleep, stress reduction techniques and regular exercise

Managing stress, achieving high-quality sleep and engaging in regular exercise and activities are key to helping control fibromyalgia symptoms like pain, fatigue and upper back discomfort

Maintaining a healthy diet and limiting caffeine intake can also support overall health and wellness.

The Connection between Fibromyalgia and Upper Back Pain

For many individuals with fibromyalgia, upper back pain is a common and debilitating symptom. In fact, studies have found that upwards of 86% of fibromyalgia patients report experiencing upper back pain.

Several factors contribute to the high prevalence of upper back pain in fibromyalgia:

Muscle stiffness

Fibromyalgia commonly causes stiffness and tightness in upper back muscles due to difficulty relaxing muscles after use. This leads to shortened muscle length and impaired flexibility over time.

Trigger points

Fibromyalgia patients often develop tender or "trigger" points in their upper back muscles that can cause acute flares of severe localized pain when pressed.

Fatigue and poor sleep 

Fatigue and nonrestorative sleep, both hallmarks of fibromyalgia, increase muscle tension in the upper back and reduce its ability to recover between flare-ups.

Central sensitization

Changes in how the brain and spinal cord process pain may lower the threshold for perceiving upper back pain in fibromyalgia patients. Even minor strains can then cause disproportionate pain.

Mood disturbances

Conditions like depression and anxiety commonly co-occur with fibromyalgia and can exacerbate perception of upper back pain through emotional and cognitive mechanisms.

For individuals with fibromyalgia, effectively managing upper back pain involves addressing both generalized fibromyalgia symptoms as well as specific issues related to the upper back. 

A multidisciplinary approach that incorporates medications, physical therapy, cognitive behavioral therapy and lifestyle modifications can provide the greatest benefit.

Management and Treatment of Fibromyalgia Upper Back Pain

Treating upper back pain in individuals with fibromyalgia requires a comprehensive and integrated approach. 

Due to the complexity of fibromyalgia, a multidisciplinary team is often needed for the best outcomes. This may include:

  • Rheumatologists to diagnose fibromyalgia and manage any systemic rheumatic issues  
  • Pain specialists to develop a tailored treatment plan     
  • Physical therapists to design and implement customized exercise programs 
  • Occupational therapists to recommend ergonomic adjustments and assistive devices   
  • Clinical psychologists for cognitive behavioral therapy and coping skills training

Medications can help alleviate upper back pain associated with fibromyalgia:

Pain relievers - Over-the-counter or prescription NSAIDs may provide some relief of acute upper back pain.

Muscle relaxants - Drugs like tizanidine and cyclobenzaprine can help reduce muscle spasms and tension that contribute to upper back pain.    

Antidepressants - Selective serotonin reuptake inhibitors (SSRIs) and SNRIs may help reduce pain sensations and improve mood.   

Anti-seizure drugs - Pregabalin and gabapentin can reduce pain signals from reaching the brain and may benefit upper back pain.

Physical therapy focuses on strengthening core and paraspinal muscles while improving range of motion and posture. Exercises for the upper back, neck and shoulders can:

  • Relieve trigger points    
  • Reduce muscle stiffness and spasms           
  • Improve balance, coordination and proprioception     
  • Enhance sleep quality and relieve fibromyalgia-related fatigue

Coping skills training includes relaxation techniques, mindfulness strategies, biofeedback and cognitive behavioral therapy to help individuals better manage stress and chronic upper back pain. 

Lifestyle modifications like spinal nerve blocks exercise, dietary changes and engagement in enjoyable activities also support comprehensive care.

Early intervention, adherence to treatment plans and engagement with a team of specialists typically results in the best outcomes for individuals with fibromyalgia upper back pain. 

An integrated care approach focused on both generalized fibromyalgia symptoms and specific issues related to the upper back provides the greatest chance of symptom relief and improved function. 

Lifestyle Modifications for Fibromyalgia Upper Back Pain

Beyond medications and physical therapy, numerous lifestyle modifications can help reduce and manage upper back pain related to fibromyalgia. These actions target both generalized fibromyalgia symptoms as well as issues specific to the upper back:


Engaging in regular aerobic exercise at a moderate intensity for at least 30 minutes three times per week can:    

  • Improve upper back muscle strength and flexibility      
  • Enhance sleep quality    
  • Reduce fatigue and pain sensations   
  • Improve mood  

Focus on low-impact exercises like walking, swimming and stationary cycling. Strength training and yoga can also benefit upper back muscles.

Proper Posture

Maintaining good posture when sitting and standing can lessen strain on the upper back. Make adjustments to:

  • Computer workstations through height-adjustable desks and chairs    
  • Seating with lumbar supports and/or cushioned seats      
  • Sleeping arrangements with supportive pillows    

Weight Loss

If you're overweight, losing as little as 5-10% of your body weight through diet modification and physical activity can help alleviate upper back pain and other fibromyalgia symptoms.      

Stress Management

Using techniques like meditation, deep breathing exercises, and mindfulness training can lessen perception of upper back pain and improve overall coping skills.    

Adequate Sleep

Ensuring you get 7-8 hours of high-quality, uninterrupted sleep per night is crucial for managing fibromyalgia symptoms and upper back pain.   

Balance Diet

Following an overall healthful diet rich in vegetables, fruits, lean proteins and whole grains can support your body's natural healing process. 

Limiting alcohol and caffeine intake may also provide additional benefits.   

Social Support

Maintaining strong connections with family, friends, and support groups can help buffer the mental health effects of fibromyalgia and chronic upper back pain.

By implementing these lifestyle modifications, individuals with fibromyalgia can gain greater control over their symptoms and live more fully in spite of ongoing upper back pain. Regularly evaluating progress and coping skills can further maximize benefits over the long-term.

Support and Coping Strategies for Upper Back Pain and Fibromyalgia

Living with fibromyalgia can be challenging, especially when accompanied by debilitating upper back pain. Fortunately, various sources of support and coping strategies can help individuals better manage their condition and improve quality of life.

Social support

Connecting with family, friends and peers who understand fibromyalgia can help reduce isolation, promote healthy behaviors and provide emotional support. Joining an online or in-person fibromyalgia support group can also help.   

Fitness programs

Exercise programs specifically tailored to the needs of individuals with fibromyalgia and upper back pain can boost confidence, improve mood and offer camaraderie with others facing similar challenges.


Speaking with a therapist can help develop coping skills to effectively manage chronic pain, fatigue, stress and emotions related to fibromyalgia. Cognitive behavioral therapy and mindfulness practices may provide additional benefits.   

Alternative therapies

Some individuals find relief through complementary and alternative therapies like acupuncture, massage therapy, chiropractic care and nutrient supplements. However, limited research supports their efficacy.   

Peer mentoring

Partnering with a peer mentor who successfully manages fibromyalgia can provide encouragement, real-world advice and accountability. However, not all strategies work for everyone.    

Positive self-talk

Using mental strategies that reinforce one's resilience, capabilities and value can boost mood, self-esteem and ability to cope with fibromyalgia and upper back pain. However, being kind to oneself is most important.


Practicing compassion toward oneself, including one's physical and emotional experiences, can help minimize depression, anxiety and psychological distress related to fibromyalgia and chronic upper back pain.   

Online resources

Websites, forums and social media groups focused on fibromyalgia provide access to information, inspiration and a sense of community for individuals living with the condition. 

Professional resources from medical centers and universities also offer research-based knowledge.

By utilizing various sources of support and reframing challenges in a positive light, individuals with fibromyalgia and upper back pain can gain confidence, build coping skills and live well despite ongoing symptoms. 

No single solution works for everyone; experimenting and tailoring approaches to one's unique needs provides the greatest chance of success

Regain Your Strength and Mobility

Living with fibromyalgia and upper back pain doesn't have to mean living with limitations. 

At Gramercy Pain Center, our team is dedicated to helping you reduce your symptoms, regain your mobility and get back to the activities you love.

Our integrative approach involves treating the whole person, not just the condition. We begin by developing a deep understanding of your unique health history, needs and goals. Then we create a personalized treatment plan that may include:

• Prescription medications to manage your pain and other symptoms   

• Customized physical therapy focusing on strengthening your upper back muscles  

• Lifestyle recommendations including dietary changes, exercise guidance and stress management techniques             

• Ergonomic assessments and adaptive devices to minimize strain on your upper back      

• Alternative therapies such as acupuncture and massage therapy               

• Psychological interventions for depression, anxiety and improved coping      

At Gramercy Pain Center, our mission is to alleviate your suffering and help you thrive - physically, mentally and emotionally.      

If you're ready to regain your strength, mobility and independence, call Gramercy Pain Center today. Our caring staff can answer your questions and help you schedule a consultation with one of our specialists.      

You deserve relief from upper back pain and the ability to enjoy life again. Taking the first step by scheduling an appointment is key toward regaining comfort and confidence. Don't delay another moment - call us today at 732-788-0349.

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