Fibromyalgia: Heat for Widespread Aches

Fibromyalgia brings widespread pain, stiffness, fatigue and poor, disrupted sleep…definitely =(

The good news is that heat is one of the few things that’s cheap, always available and entirely under your control, which is why so many people with fibromyalgia keep a pad within reach.

It’s a comfort measure, not a treatment. Used well, it makes the thing that does help, movement, more possible. That sequence is spelled out in “my physio said use heat” — but how, exactly?

Why heat suits it

Fibromyalgia involves a nervous system that amplifies pain signals.

Sensations that wouldn’t bother most people register as painful. On top of that, people in persistent pain hold muscles tight, and that guarding becomes its own source of ache. Tender spots in that tight muscle behave much like ordinary muscle knots, though they need a far gentler hand.

Warmth works on both. It relaxes the guarding, and it gives your nervous system a competing, pleasant signal. Many people describe warmth as one of the few inputs that reliably feels good rather than provoking.

Practical use

• Pick one or two areas per session rather than chasing pain around the body. Wherever is loudest today.
• Lowest setting, 15–20 minutes, with proper breaks. Skin sensitivity is often heightened, so start lower than you think you need.
• Morning, before you start moving. Stiffness is often worst then, and warmth makes the first movements easier. The same trick works for stiff hands and stiff hips first thing.
• Before gentle exercise rather than instead of it.
• A warm shower or bath does the same job over more of the body, and many people prefer it. See moist heat vs dry heat.

Because use tends to be daily and long-term, move the pad around rather than using the same spot every time, and watch for a lasting net-patterned stain.

See

• toasted skin syndrome and
• how long to use a heating pad
• who should not use a heating pad

What has the most evidence

Exercise, built up very gradually. This is the strongest recommendation in fibromyalgia guidelines, and also the hardest, because doing too much too soon causes a flare. Start smaller than feels worthwhile and increase slowly. Walking, water-based exercise and gentle strength work all have support.

Pacing. Working to a level you can repeat tomorrow rather than to how you feel today. See heat on chronic pain flare days.

Sleep. Poor sleep and fibromyalgia pain feed each other directly. Sleep is worth treating as a priority in its own right. See warmth before bed, and note that the pad goes off before you do: sleeping with a heating pad.

Psychological approaches. Cognitive behavioural therapy and similar approaches have decent evidence. That is not a statement that the pain is imagined; it’s about giving the nervous system less to amplify.

Medication helps some people. Ordinary painkillers often disappoint in fibromyalgia, which is worth knowing so you don’t conclude nothing works. Discuss the options with your doctor.

Being believed

Many people with fibromyalgia spend years being told their tests are normal and there’s nothing wrong. Normal tests are expected in fibromyalgia. It’s a recognised condition with recognised management, and the pain is real.

If you feel dismissed, ask for a referral to a rheumatologist or a pain clinic.

See a doctor if…

• Something changes: a new type of pain, a swollen joint, a rash, or fever. A hot, swollen joint is a different problem: see heat for knee and joint pain and rheumatoid arthritis.
• You have new weakness, numbness, or trouble with balance
• You’re losing weight without trying
• Your mood is suffering badly. Low mood is common alongside persistent pain and is treatable.

Fibromyalgia doesn’t rule out other conditions developing, so changes in pattern are worth checking rather than absorbing into the diagnosis.

Clinically reviewed by: Nigel Chua (Hand Occupational Therapist) & Louise Yow (Physiotherapist). This article is general information, not a diagnosis. electricheatpad.com sells electric heat pads.