It happens in patients with fibromyalgia: the secret was hidden in the nervous system, not in the skin.
The intense and persistent itching reported by many people with is not, in most cases, a skin problem.
According to research, this is often a neuropathic itching, a symptom generated by changes in the nervous system, and not by irritation on the skin’s surface.
Fibromyalgia is a chronic disorder marked by widespread pain, fatigue and sleep disturbances. Itching has long been associated with this condition, as well as other diseases with neuropathic pain, such as diabetes, herpes and some forms of arthritis.
The difference, authors and experts, is that in neuropathic itching the origin lies in dysfunction of the central nervous system (brain and spinal cord) or peripheral nerves, which start sending excessive or inadequate signals.
In the specific case of fibromyalgia, the relationship between pain and itching is framed by the concept of central sensitization: a state in which the nervous system processes sensory stimuli in an amplified way. This can translate not only into pain upon light touch, but also into sensations such as tingling, burning, numbness and “crawling sensation” on the skin.
In an interview with the Fibromyalgia Association UK, specialist Dr. Mark Pellegrino describes the phenomenon as an overactivity of receptors and nerves that makes the skin hypersensitive, producing autonomic symptoms and vascular changes that can affect thermal sensation and the appearance of the skin.
The text also highlights the role of “silent nociceptors” — fibers that, under normal conditions, remain inactive and can become hyperexcitable after inflammation or injury. A 2013 report cited by indicates that around 77% of patients with fibromyalgia had these nociceptors in a state of hyperexcitability.
The proximity between pain and itching also has therapeutic implications. Studies mentioned indicate that drugs used in neuropathic pain, such as gabapentin, pregabalin and some antidepressants, can alleviate chronic itching, while analgesics such as opioids sometimes tend to trigger itching.
For dermatologist Gil Yosipovitch, pain and itching share biological “circuits”, but are interpreted differently by the brain, which influences both research and treatment. Among the data cited, one from 2020 reports that around 60% of patients in a clinical sample with fibromyalgia experienced chronic itching. One from 2024 adds that, among painful conditions associated with itching, neuropathic pain appears as the most prevalent.
