Muscle Stiffness And Pain

There are many different reasons why people can experience muscle stiffness and muscle pain. Typically it is because of a traumatic injury which can include sprains, strains, bruising or wounds that involve the muscle tissue. When this happens the nociceptors, which are located in the skin and underlying layers of tissue, trigger the pain response that travels from the peripheral nerves to the central nervous system. The spine carries the nerve message to the brain, where the brain decodes the pain and triggers the appropriate response.

The brain also triggers the production of opioids, the endorphins, which act as natural analgesics that block the same continual pain message. This is the same action that painkillers have in the body. This allows the brain and central nervous system to regain homeostatis or balance and prevents the body from continually sensing pain. It also creates a pain threshold in the body that allows humans to detect mild, moderate and severe pain as well as different types of pain.

When the body is under stress, which means there is an abundance of the stress hormone cortisol, the normal pain response becomes altered. The body becomes hypersensitive to pain and the natural opioid response is not effective in minimizing feelings of pain. In addition, even slight touch or pressure can create the sensation of pain as neurons misfire without any checks and balances in the system. The result is chronic pain and increased muscle stiffness due to the imbalance in the brain and the central nervous system.

Tender Points

For people with fibromyalgia, the pain is chronic and may include deep muscle pain, pain with even gentle touch, painful tender points on the body and increased morning stiffness. Tender points are particularly problematic as these small spots on the body can cause incredible pain levels even with gentle pressure from a finger. They cannot be identified by any physical difference in the surrounding tissue and are not the same as a trigger point, which is a hard lump, found in myofascial pain syndrome or MPS.

While not deep muscle pain, collections of tender points around the neck, back, hips, buttocks and the knees may contribute to the sensations of pain in surrounding muscle tissue. In some research it has been found that MPS trigger points and the tender points associated with fibromyalgia may, in fact, be the same type of condition. The MPS trigger points increased the likelihood of pain to deep muscle tissue which is due to central sensitization or the hypersensitivity of the central nervous system to any pain. 1

Muscle Pain And Changes

In muscle biopsies of people with fibromyalgia there have been some abnormalities noted in the muscle structure at a cellular level. Different researchers have shown that there are some chemical changes, but the greatest change is in cellular damage and abnormal mitochondria in the individuals with fibromyalgia. There may also be a decreased blood supply to muscles most commonly associated with pain in fibromyalgia, including the trapezius muscle. This tends to indicates that muscle change is not the cause of muscle pain in fibromyalgia, but that muscle atrophy and changes in mitochondria do play a role. 2

Muscle Stiffness

People with fibromyalgia most commonly report muscle stiffness that decreases in severity as the day progresses. This is typically referred to as morning stiffness and may affect as many as 70% of all people diagnosed with fibromyalgia. Not all people have this condition chronically, in some it comes and goes based on stress, environmental factors, health factors and activity levels. Temperature, especially cold or humid conditions tends to aggravate the condition as do times of physical or emotional stress and difficulties in sleeping or chronic sleeping problems.

Most individuals describe this morning stiffness as a sense of tightness and restricted range of motion throughout the entire body. It can affect the fingers, toes, hands and feet as well as the larger muscles of the body. Some individuals find that this stiffness develops even after long or short periods of sitting, including traveling in a car. It can be accompanied by sharp, shooting pains as joints and muscles are stretched or it can be a dull, throbbing pain that becomes more or less apparent throughout the day. The lower back, upper back, neck and legs are particularly prone to this complication or symptom of fibromyalgia.

Working Through Muscle Pain And Stiffness

High levels of corticosteroids in the body and the brain produce hypersensitivity to pain and also create the condition for central sensitization to occur. In turn chronic pain and stiffness contributes to mental stress and the ability to lead a physically active life. The more that muscle pain and stiffness interferes with the life of an individual, the greater the chance of serious quality of life changes including the inability to work, socialize and even interact with people.

Unfortunately for people with fibromyalgia, traditional exercise may not help in alleviating pain and stiffness. However, in a study of women that trained for eight months in warm water with a supervised training program the results were positive. Of the group of 30 women there was an improvement of 8% in levels of pain, 41% in symptoms of anxiety and 27% in symptoms of depression. In addition there was an improvement of 20% in reporting of physical functioning, which included walking, stair-climbing and aerobic fitness.3 Other studies have shown even greater improvements in symptoms with exercise. This may provide an option for adjuvant therapy to medications in controlling the painful symptoms of fibromyalgia.


1 Ge, H.-Y., Wang, Y., Danneskiold-Samsoe, B., et al. (2010). The Predetermined Sites of Examination for Tender Points in Fibromyalgia Syndrome Are Frequently Associated With Myofascial Trigger Points. The Journal of Pain , 644-651.

2 Bengtsson, A. (2002). The muscle in fibromyalgia. Rheumatology , 721-724.

3 Tomas-Carus, P., Gusi, N., Hakkinen, A., et al. (2008). Eight Months of Physical Training in Warm Water Improves Physical and Mental Health in Women with Fibromyalgia: A Randomized Controlled Trial. Journal Of Rehabilitative Medicine , 248-252.ion of medication which results from reading this site.

This article was originally published on July 11, 2012 and last revision and update of it was 9/7/2015