What Causes Chronic Pain All Over The Body? Understanding Widespread Pain and How to Treat It
If you’ve felt full body soreness after a hike, gardening, or a long walk, activities that usually feel easy for you, you might be wondering what causes chronic pain all over the body.
Or maybe you notice your pain seems to migrate around your body without a clear reason.
This widespread pain can feel confusing or even a little unsettling. But it’s important to know that it doesn’t mean there’s anything wrong with you or your body.
In fact, pain that shows up in more than one part of your body can have several contributing factors, including inflammation, nervous system sensitization, stress load, deconditioning, and movement avoidance.
In my work with active adults in Bend, I often see patients who have tried many approaches to pain care without significant improvement.
It’s not that these approaches are wrong, but sometimes they miss the bigger picture, especially the role of the nervous system and how your thoughts and beliefs about pain can influence your experience.
In this article, we’ll explore some of the most common reasons people experience chronic pain all over the body and what may help you better understand and manage it.
Understanding chronic widespread pain
First, it’s important to understand the difference between acute and chronic pain.
Acute pain is a protective response that signals actual or potential tissue damage. It usually resolves within the expected healing time of the injured tissue, which ranges from days to weeks. Pain lasting longer than about 3 months is generally considered chronic.
Chronic pain occurs when our normal protective response persists and becomes maladaptive. When pain sticks around, people often start to avoid activities out of fear of a flare-up of pain. Over time this can lead to a significant decrease in their participation in activities that support their active lifestyle and well-being, like hiking, gardening, or weight training.
The way you think about your pain can reinforce pain-related fear. If you believe pain equals tissue damage, it makes sense you would be fearful of pain. However, the more fear you have of pain, the more likely it is to stick around because the pain itself becomes a threat, keeping your nervous system on high alert. This can unintentionally keep the pain cycle going.
How people around you respond to pain can also influence your perception of pain. For example, if your family valued stoicism, you might dismiss your pain. If your culture believes all pain is bad and means something is wrong, you might be hyper-aware of pain.
What is considered widespread pain?
Pain that occurs in multiple body regions, especially when they are unrelated to each other or to a specific injury.
Pain that migrates from body region to body region without a clear reason.
How the nervous system contributes to persistent pain
When pain lasts longer than expected, your nervous system might become more sensitive. This is often referred to as sensitization.
Your nervous system is designed to keep you safe. When you have an acute injury, this protective system is helpful because it gives you feedback to modify movements, like limping when you have a sprained ankle or avoiding reaching overhead when you have a sore shoulder, to minimize irritation to the healing tissue.
However, sometimes this protective system stays turned up even after your injury has healed. When this happens, it takes less input to send a signal to your brain that there might be danger and your brain is more likely to trigger a pain response.
You might think of it like an alarm system that has become too sensitive. At first the alarm only goes off when someone breaks a window. But over time, the alarm might go off when the wind blows or someone walks by the house.
When the nervous system becomes sensitized, everyday activities that previously felt normal, like running, hiking, sitting at your desk, cooking, or showering, might begin to trigger pain. It doesn’t mean your body is damaged, but rather your nervous system has become more protective.
Pain is more complex than simply a signal from injured tissue. When you experience pain, your brain is processing information from many sources including signals from your body, past experiences, emotions, stress levels, sleep quality, nutrition, and physical activity. Your brain evaluates this information and determines whether the situation is threatening enough to produce pain. So, you could experience pain even if there’s no actual tissue damage.
This is why persistent pain is more complex that it initially appears. It’s influenced by many different factors like physical stress on the body, emotional stress, sleep disruption, inflammation, and activity levels.
Understanding the role of the nervous system helps explain why chronic pain treatment often involves more than simply treating injured tissues. It often includes addressing the mind-body connection, adopting a curious mindset, gradually rebuilding movement and activity tolerance, supporting the nervous system, improving recovery and sleep, and helping the body feel safe enough to move again.
Common medical conditions behind full body pain
Chronic, full body pain is a symptom, not a diagnosis. There are many conditions that present with widespread pain including fibromyalgia, autoimmune conditions, hormonal causes, and nerve-related pain conditions.
Full body pain can be related to stress with higher stress levels associated with an increase in pain experiences.
Additionally, widespread body pain often leads to a fear of movement and avoidance of potential aggravating activities. Over time, the fear and avoidance of movement can lead to deconditioning and the less conditioned our tissues are the harder our day-to-day activities can feel, which creates a challenging pain-activity avoidance pattern.
Fibromyalgia and central sensitization
Fibromyalgia is a condition that causes widespread pain and tends to affect women more commonly. It is thought that the nervous system plays a role in fibromyalgia symptoms.
The symptoms vary person to person, but commonly include:
Pain in various joints and body regions
Fatigue
Sleep problems
Brain fog
Depression or anxiety
Headaches
Digestive problems
Urinary issues
Pelvic pain
Understanding central sensitization
Central sensitization is related to the nervous system sensitivity we discussed earlier. In this state, the nervous system becomes more reactive, sending signals to the brain even when there’s little to no tissue damage.
For people living with fibromyalgia, this heightened sensitivity can lead to pain in multiple areas of the body along with fatigue, sleep disturbances, and brain fog.
Autoimmune disorders and inflammation
Our immune system is designed to identify “invaders” in our body like viruses or bacteria and to send out cells that eliminate those invaders to keep us healthy.
With an autoimmune disorder, our immune system is more active than it should be and mistakenly targets healthy tissues like muscles, joints, nervous system, and organs.
Some common autoimmune conditions that are linked to widespread pain include:
Rheumatoid arthritis which can cause joint pain, swelling, and stiffness
Lupus causes inflammation of organs like the kidneys and lungs as well as skin rashes, fatigue, and joint pain
Ankylosing spondylitis is a chronic inflammatory condition that primarily affects the spine and causes pain, stiffness, and potentially fusion of the joints over time
While these are medical conditions your physician would diagnose, physical therapy can still play a role in managing the joint and muscle pain, stiffness, and help with supporting activity while considering the impact of these conditions on energy and fatigue levels.
Hormonal and metabolic causes
Hormones help to control pain sensitivity by acting as messengers that regulate nerve activity, inflammation, and neurotransmitter levels, which are necessary for regulating brain function, body movements, mood, and sleep.
Hormonal conditions that may contribute to widespread chronic pain include:
Thyroid disorders - with low thyroid function, people often experience fatigue, muscle aches, and joint pain
Perimenopause and menopause - an abrupt decline in estrogen levels often leads to joint pain, muscle aches, and a decline in bone density
Vitamin deficiencies - certain vitamin and mineral deficiencies can lead to inflammation, decreased bone and muscle strength, and nerve dysfunction
Metabolic disorders - can cause widespread inflammation, pain, fatigue, and damage to nerves
The connection between fatigue and systemic health
Fatigue is a predominant symptom of systemic inflammatory states and can create a cycle of decreasing physical activity leading to overall decreases in functional health.
In addition, systemic inflammation can increase nervous system sensitivity and this increase in sensitivity can become a contributor to chronic fatigue.
Nerve-related pain conditions
Neuropathic pain is often described as sharp, stabbing, burning, or shooting pain, numbness or tingling, or sensitivity to light touch. It is pain that originates from damage to our nerves or a nervous system that is not functioning appropriately.
Neuropathic pain differs from muscle soreness in that muscle soreness is often described as a dull, aching discomfort that may be related to exercise or a strain and typically resolves within a few days.
Some conditions that can affect nerve function include:
Peripheral neuropathy most commonly causes weakness, numbness, and/or pain in the hands and feet. It is most often associated with diabetes but can also be attributed to vitamin deficiencies and alcohol abuse
Nerve entrapment syndromes occur when a nerve becomes compressed, overstretched, or adhered to surrounding tissues which restricts its mobility. Nerve entrapments can occur in many places throughout the body with the most common being carpal tunnel syndrome and sciatica.
Post-viral nerve irritation can result in symptoms like burning, numbness, or tingling and can occur in cases of Long Covid or post-shingles.
Lifestyle and stress factors
In addition to medical and physiological factors discussed above, lifestyle and stress can also play a role in the sensitivity of the nervous system. As we introduced earlier, when the nervous system becomes more sensitive, it also becomes more protective and it takes less input to trigger pain.
Periods of prolonged stress keep the body in a heightened alert state, which can increase muscle tension, disrupt sleep, and make the nervous system more reactive. Over time this heightened sensitivity can contribute to widespread aches and pain throughout the body.
When to seek medical evaluation
If you’ve been experiencing pain for more than 3 months and it is impacting your daily activities including work, eating, and/or sleeping or continues to worsen even with self-treatment strategies, it’s time to see a medical provider.
Symptoms that warrant immediate evaluation by your medical provider include:
Unexplained weight loss
Persistent fever or illness
Progressive neurological symptoms such as weakness, bowel or bladder incontinence, or numbness or tingling in the saddle region
Significant changes in energy levels
Where to find physical therapy in Bend, OR for chronic pain all over the body
Treatment for chronic pain all over the body requires a whole-person approach that integrates nervous system support, gradual re-introduction of movement and strength, balance of stress and recovery, as well as education and reassurance that the pain you are experiencing can improve.
Holistic physical therapy and chronic pain PT can help by assessing your movement patterns, explaining your pain in digestible ways, integrating tools that support your nervous system, and co-creating an individualized activity progression.
If you’re in or near Bend, OR and chronic pain all over your body is limiting your activity or quality of life, working with a provider who will approach your care both holistically and with compassion can be an important part of your pain recovery process.
You can get started by learning more about chronic pain physical therapy and holistic PT in Bend, OR, or by getting in touch with me.
If you have questions, I’d love to connect, hear how chronic pain is affecting your lifestyle and well-being, answer your questions, and explore how I can help.
You can schedule a free consultation here.
Disclaimer: this post is intended for informational purposes only and is not medical advice. If you are experiencing pain, it is always in your best interest to consult with your medical doctor and/or your physical therapist.
