Pruritus and Fibromyalgia
If you know much about fibromyalgia, you’ve no doubt heard the list of most common symptoms: chronic fatigue, widespread pain in the joints of the body, mental fog and difficulty remembering basic things, and mental symptoms like depression. But the thing about fibromyalgia is that it’s never that simple. There are a wide number of different symptoms you might not think of. And one of the most annoying to deal with might be pruritus.
Pruritus is a medical term that describes a kind of chronic itching. A lot of things can cause pruritus like dry skin or allergies. But it’s also surprisingly common in chronic pain conditions like fibromyalgia. So what is it about chronic pain conditions that causes pruritis? And what can you do to treat it?
Pruritis and Fibromyalgia
Many people who suffer from fibromyalgia report constantly feeling itchy. Typically, the sensation is worse at night and people with this kind of pruritis often find it difficult to sleep. Instead, they’re up all night scratching their skin until it’s raw. And if you’ve ever had an itch that you just can’t seem to scratch, you know how infuriating that is.
But what’s interesting is how common this itching is among people with fibromyalgia while, at the same time, few people seem to associate chronic itching with fibromyalgia. So why do these conditions seem to go together?
Well, to answer that question, it’s worth considering the fact that fibromyalgia isn’t the only chronic pain condition that seems to cause pruritis. And doctors have speculated that the basic neurological mechanisms that cause chronic pain are the same mechanisms that cause chronic itching.
It’s possible that the misfiring nerve signals that transmit the sensation of chronic pain become more sensitive to all forms of stimulus. And thus, sometimes they transmit the sensation of itching, even without any obvious cause. Unfortunately, the field of chronic itching isn’t one that gets a lot of attention when it comes to research, so it may be awhile before we get any good answers about the cause of pruritis.
How do you treat Pruritus?
One of the most important things when it comes to pruritus is not to scratch. Obviously, this is a case of “easier said than done.” But scratching your itch can actually make the condition worse. Doctors call this the “itch-scratch cycle.” When you scratch, you not only damage your skin but actually activate the nerve fibers that cause the itching sensation.
So while a good scratch might help relieve the itch in the short-term, it’s a self-defeating way to deal with itching.
There are a few different medication-based options that are better for treating itching. Typically, some of the basic over-the-counter stuff is not as effective for cases of pruritus, since the itching is not originating in the skin itself but rather in the nerves. So the sorts of anti-histamine creams that you would use for allergy-related itching or the moisturizers you might use for dry skin won’t be as helpful for pruritus as they would be for the conditions they are designed to treat.
But with that being said, they aren’t completely useless. One of the most common treatments for pruritus is a specific type of moisturizer designed to help repair the barrier between the skin and the air. Studies have shown that moisturizers with a low pH balance are effective for treating the condition. The best explanation for their effectiveness is that they help deactivate certain receptors in the skin cells that trigger pruritus, though we aren’t completely sure of that yet.
And clinical trials have also shown a lot of success with a certain class of drug designed to prevent seizures. Gabapentin works by slowing down the interaction between neurons in the brain. This helps stop the rapid-firing interaction between neurons that leads to seizures. But something about the way the drug helps dull the interaction between nerves seems to prevent the itching stimulus as well.
The drug is actually regularly prescribed in countries like New Zealand, where doctors are aware of its effectiveness for treating cases of pruritus. Of course, like any drug, it carries side effects. So it may not be for everyone.
Fortunately, there are also some natural ways to relieve pruritus. Avoid hot showers, which can make the itching worse. Limit your consumption of caffeine and aspirin, both of which are known to increase the severity of itching. And there’s even some evidence that medical marijuana might help cure pruritus.