Fibromyalgia is a complex chronic pain disorder that affects millions of people worldwide, causing widespread pain, fatigue, sleep disturbances, cognitive issues, and sensitivity to stimuli. But among its many challenging symptoms, one stands out for its intensity and emotional impact: the burning sensation. Many people with fibromyalgia describe it as if their skin, muscles, or nerves are “on fire,” “sunburned,” “raw,” or “burning from the inside.” This type of pain can be alarming, unpredictable, and extremely disruptive to daily life.
Although burning sensations are not as universally recognized as other types of fibromyalgia pain, they are surprisingly common. Understanding why this burning occurs is crucial—not just for symptom relief, but also for validating the lived experience of patients who feel misunderstood or dismissed. This article explores, in depth, the physiological, neurological, hormonal, emotional, and environmental factors that contribute to burning sensations in fibromyalgia, as well as practical strategies to manage them.
The goal is to help you understand the full picture: what causes burning pain, why it seems random or disproportionate, and what steps you can take to soothe your nervous system and regain a sense of control.
Burning Pain: The “Silent Signal” of Nervous System Overload
Burning sensations in fibromyalgia are a type of neuropathic pain—pain that originates from dysfunctional or hypersensitive nerves. Unlike muscle soreness or joint stiffness, burning pain arises from miscommunication in the nervous system. It does not necessarily indicate tissue damage, inflammation, or injury, even though it feels intensely hot or irritated.
In healthy individuals, burning pain usually appears when there is:
- Actual heat exposure
- Chemical irritation (like a rash or burn)
- Nerve injury
- Inflammation
But in fibromyalgia, burning pain occurs in the absence of physical harm. This is because the nervous system has become overly sensitive, interpreting ordinary sensations as painful or sending pain signals without any external trigger.
This phenomenon is called central sensitization—and it sits at the core of fibromyalgia.
Central Sensitization: Why Your Nervous System Misfires
Central sensitization refers to a state where the brain and spinal cord amplify pain signals. Imagine your nervous system as a stereo with the volume knob stuck on high. Even minor sensory input—light touch, temperature changes, stress, digestion—can feel overwhelming.
Burning pain emerges when:
- Sensory nerves fire constantly
- Pain pathways strengthen
- The brain misinterprets normal signals as danger
- The spinal cord amplifies sensory messages
- Inhibitory “brake systems” in the brain weaken
The longer central sensitization persists, the more likely the brain is to default to painful sensations such as burning, tingling, stinging, or electric-shock-like sensations.
But what creates this hypersensitive state? Fibromyalgia research points to multiple overlapping causes.
Reason #1: Nerve Fiber Dysfunction and Small-Fiber Neuropathy
A growing body of research shows that many people with fibromyalgia have dysfunction of the small nerve fibers—the nerve endings responsible for detecting temperature, pain, and chemical stimuli. In some cases, these nerves become:
- Damaged
- Overactive
- Miswired
- Hypersensitive
This condition is called small-fiber neuropathy, and it can produce:
- Burning pain (the most common symptom)
- Tingling
- Numbness
- Pins and needles
- A sense of hot liquid running under the skin
While not every fibromyalgia patient has this type of neuropathy, a significant portion do, which explains why burning sensations are so common.
The nerves most affected include:
- C fibers: slow pain fibers that produce dull, burning pain
- A-delta fibers: fast pain fibers that produce sharp, stinging sensations
When these fibers malfunction, the brain receives distorted signals that it perceives as burning.
Reason #2: Neuroinflammation (“Inflamed” Nerve Networks)
Fibromyalgia doesn’t cause the same kind of inflammation you’d see in arthritis or infections. Instead, it involves neuroinflammation, which means inflammation within the nervous system rather than the joints or tissues.
In neuroinflammation:
- Brain cells called microglia become activated
- Chemical messengers like cytokines increase
- Pain pathways become more reactive
- Nerves fire abnormally
This inflammatory state does not cause visible redness or swelling, but it can produce a burning sensation that feels like inflammation.
Neuroinflammation also:
- Exaggerates temperature sensitivity
- Intensifies muscle and skin discomfort
- Triggers nerve irritation without physical injury
This explains why a mild sunburn-like feeling can appear in random areas of the body, then disappear, then reappear elsewhere.
Reason #3: Autonomic Nervous System Imbalance
The autonomic nervous system (ANS) controls involuntary functions such as:
- Heart rate
- Body temperature
- Blood flow
- Sweating
- Digestion
In fibromyalgia, the ANS tends to be in overdrive, especially the sympathetic branch (“fight or flight”). When this happens:
- Blood vessels constrict or dilate erratically
- Skin can feel hot or burning
- Muscles receive inconsistent blood flow
- The body misprocesses heat and temperature signals
Many people with fibromyalgia also develop symptoms similar to dysautonomia or POTS (postural orthostatic tachycardia syndrome), which can further distort temperature regulation.
Burning flare-ups often occur:
- After standing for long periods
- During weather changes
- After stressful events
- During hormonal shifts
- After exercise or physical exertion
ANS dysregulation is a major contributor to temperature-related burning sensations.
Reason #4: Muscle Tension and Ischemia (“Low Oxygen Pain”)
Tight muscles are a hallmark of fibromyalgia. When muscle fibers are chronically contracted, they:
- Receive less oxygen
- Accumulate waste products
- Become fatigued
- Irritate surrounding nerves
This produces ischemic pain—a type of discomfort that often feels:
- Burning
- Throbbing
- Heavy
- Cramping
- Deeply aching
Burning sensations in the neck, shoulders, back, and calves are often related to chronic muscle tension paired with nerve hypersensitivity.
Even small activities—like sitting too long, looking down at a phone, or walking upstairs—can increase muscle tension to the point of creating burning flare–ups.
Reason #5: Skin Sensitivity and Allodynia
Allodynia is a condition where normally non-painful stimuli become painful. In fibromyalgia, the skin becomes hypersensitive, causing sensations like:
- Burning
- Tingling
- Prickling
- Feeling sunburned
- Pain from clothing touching the skin
- Pain from light pressure or movement
Allodynia is one of the clearest signs of central sensitization.
It can be triggered by:
- Temperature changes
- Fabrics brushing against the skin
- Hot showers
- Cold air
- Stress or anxiety
- Hormonal fluctuations
When the skin’s sensory nerves send distorted signals to an oversensitive brain, the result is burning pain even without injury.
Reason #6: Visceral Pain and Organ Hypersensitivity
The burning sensation in fibromyalgia isn’t limited to muscles and skin. Many patients experience internal burning, such as:
- Burning stomach
- Burning bladder
- Pelvic burning
- Chest or ribcage burning
- Esophageal burning unrelated to reflux
This is a form of visceral hypersensitivity, where the internal organs become overly reactive.
Conditions that overlap with fibromyalgia include:
- Irritable bowel syndrome (IBS)
- Interstitial cystitis / bladder pain syndrome
- Pelvic floor dysfunction
- Gastroesophageal hypersensitivity
- Endometriosis or pelvic neuralgia
Internal organs are richly connected to the autonomic nervous system, which is already dysregulated in fibromyalgia. This makes visceral burning a common symptom.
Reason #7: Hormonal Imbalances and Temperature Misregulation
Hormones influence pain perception, nerve signaling, and body temperature. Many fibromyalgia patients experience burning sensations that worsen during:
- Menstrual cycles
- Perimenopause
- Menopause
- Pregnancy
- Thyroid dysfunction
Common hormonal patterns include:
- Low estrogen (leading to heat intolerance and pain sensitivity)
- Cortisol imbalance (stress hormone dysregulation)
- Low testosterone (in all genders)
- Estrogen dominance (heightened sensory sensitivity)
Hormone-driven temperature changes often produce burning sensations in:
- Hands
- Feet
- Chest
- Thighs
- Abdomen
- Pelvic region
Even subtle hormonal shifts can create dramatic sensory changes in an already sensitive nervous system.
Reason #8: Stress, Trauma, and Emotional Overload
Stress does not cause fibromyalgia, but it profoundly affects symptoms. Emotional overload activates the sympathetic nervous system, tightening muscles and amplifying pain signals.
During stress, the brain releases:
- Adrenaline
- Cortisol
- Pro-inflammatory chemicals
These substances make sensory nerves fire more easily, which increases burning sensations.
Additionally:
- Past trauma
- PTSD
- Unresolved emotional conflicts
- High-stress lifestyles
- Sleep deprivation
all prime the nervous system to overreact.
For many, burning sensations flare during:
- Emotional arguments
- Overstimulation
- Exhaustion
- Panic or anxiety episodes
- Surprises, loud noises, or sudden changes
The burning sensation is the body’s alarm system stuck in the “on” position.
Reason #9: Weather Sensitivity and Environmental Triggers
People with fibromyalgia often notice symptoms get worse during:
- Hot weather
- High humidity
- Cold air
- Storm fronts
- Rapid barometric pressure changes
Burning sensations intensify because:
- Temperature regulation is impaired
- Heat dilates blood vessels
- Cold tightens muscles
- Humidity influences nerve conduction
- Pressure changes affect fluid distribution in tissues
Even sunlight, wind, or air conditioning can trigger burning skin sensitivity.
Reason #10: Vitamin Deficiencies and Nutrient Imbalances
Nutrients play essential roles in nerve function and pain modulation. Deficiencies in the following can cause burning or neuropathic sensations:
- Vitamin B12
- Vitamin B6
- Vitamin D
- Magnesium
- Omega-3 fatty acids
- Iron
Low B12 or B6 can mimic or worsen small-fiber neuropathy. Vitamin D deficiency is extremely common in fibromyalgia and contributes to nerve pain and muscle burning.
Correcting deficiencies can sometimes reduce burning sensations—but always under medical guidance.
Reason #11: Medication Sensitivity and Side Effects
Some medications, including those used for pain, anxiety, or sleep, can cause burning sensations as side effects. This is especially true in individuals with hypersensitive nervous systems.
Possible medication-related triggers include:
- Certain antidepressants
- Lyrica or gabapentin dosage changes
- Withdrawal from medications
- Corticosteroids
- Some antibiotics
- Hormonal treatments
If burning pain appears after a medication change, consult a healthcare provider.
Reason #12: Poor Sleep and System Overload
Sleep is when the nervous system repairs itself. Poor sleep leads to:
- Higher nerve excitability
- Increased inflammatory cytokines
- Lower pain thresholds
- Reduced stress resilience
After nights of poor rest, burning sensations often worsen. Many patients report morning “skin burning” due to:
- Lack of REM sleep
- Muscle tension
- Autonomic dysregulation
- Heightened pain sensitivity upon waking
Improving sleep quality can significantly reduce burning symptoms.
Reason #13: Metabolic Stress and Energy Shortage
Fibromyalgia often involves mitochondrial dysfunction—cells struggle to produce adequate energy. When tissues lack fuel:
- Muscles fatigue faster
- Nerves misfire
- Acids accumulate
- Burning sensations intensify
This is why physical exertion, even mild activity, can trigger burning pain, often hours or days later (post-exertional malaise).
How Burning Sensations Manifest in Fibromyalgia
Burning pain can appear anywhere, but common areas include:
- Back
- Shoulders
- Face and jaw
- Arms
- Thighs
- Shins
- Hands and feet
- Chest
- Abdomen
- Pelvis
- Scalp
It may feel:
- Superficial (skin burning)
- Deep (muscle burning)
- Internal (organ burning)
- Nerve-specific (nerve-burning paths)
Some experience:
- Hot-and-cold flashes
- Burning followed by numbness
- Alternating burning and stinging
- Redness or flushing during episodes
The unpredictability is one of the most distressing aspects.
Practical Strategies to Reduce Burning Sensations
1. Cool the Nervous System
- Controlled breathing
- Meditation
- Gentle stretching
- Mindfulness
- Progressive relaxation
These techniques reduce sympathetic overdrive.
2. Improve Sleep
- Consistent sleep schedule
- Limit screens before bed
- Gentle evening routine
- Sleep supplements (discuss with a doctor)
3. Support Nerve Health
- B-complex vitamins
- Magnesium
- Omega-3s
- Vitamin D
- Hydration
4. Reduce Muscle Tension
- Warm baths
- Light exercise
- Yoga
- Massage
- Epsom salt soaks
5. Manage Stress
- Therapy
- Journaling
- Somatic therapy
- Nature exposure
6. Cool Topicals
- Aloe vera gel
- Menthol creams
- Non-irritating lotions
7. Anti-inflammatory Nutrition
- Whole foods
- Omega-3–rich meals
- Low histamine if sensitive
- Avoid excessive sugar and processed foods
8. Address Hormonal Factors
- Track symptoms around cycles
- Discuss hormonal patterns with a physician
9. Avoid Triggers
- Overexertion
- Extreme temperatures
- Tight clothing
- Perfumes or chemicals
- Stressful environments
Frequently Asked Questions (FAQs)
1. Is burning skin a common fibromyalgia symptom?
Yes. It’s a recognized part of fibromyalgia’s sensory amplification patterns.
2. Does burning mean something is inflamed or damaged?
Usually not. In fibromyalgia, burning often comes from nerve hypersensitivity rather than tissue damage.
3. Why does my skin burn even when nothing touches it?
This is a form of neuropathic pain caused by central sensitization.
4. Can burning sensations come and go suddenly?
Yes. Nervous system fluctuations can cause rapid shifts.
5. Are burning sensations dangerous?
They feel intense but rarely indicate physical harm.
6. Can fibromyalgia cause burning in internal organs?
Yes. Visceral hypersensitivity is common in fibromyalgia.
7. Can stress make burning worse?
Absolutely. Stress intensifies nerve firing and sympathetic activity.
8. Do medications help?
Some people benefit from anti-neuropathic medications, though results vary.
9. Do hot showers help or worsen burning?
Both are possible—some people improve with heat, others worsen due to heat sensitivity.
10. Can burning sensations improve over time?
Yes. With proper management and nervous system regulation, many people experience fewer and less intense burning episodes.
Conclusion
The burning sensation in fibromyalgia is one of the most misunderstood symptoms, but also one of the most scientifically explainable. It stems from a combination of nerve hypersensitivity, central sensitization, autonomic imbalance, microvascular changes, neuroinflammation, hormonal influences, and emotional factors.
This burning is not imagined, exaggerated, or psychological. It is the result of a nervous system stuck in high-alert mode—a system that has learned to overreact to even the smallest stimuli.
Understanding this helps reduce fear, frustration, and self-blame. It empowers you to take steps that calm the nervous system, nourish nerve health, and rebalance your body’s internal signals.
Burning sensations may be part of fibromyalgia, but they do not define your life. With knowledge, support, and consistent care, the intensity and frequency of these symptoms can gradually diminish, helping you reclaim comfort, confidence, and control.
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