Castro Domínguez Francisco

The relationship between irritable bowel syndrome and musculoskeletal pain is increasingly recognized, as many patients with irritable bowel syndrome experience chronic pain not only in the gastrointestinal system but also in the musculoskeletal system. This connection between irritable bowel syndrome and musculoskeletal pain may be influenced by several factors:

1. Central sensitization

Central sensitization is a process in which the nervous system becomes more sensitive to stimuli, leading to heightened pain responses. In irritable bowel syndrome, central sensitization may contribute to an exaggerated pain response, not only in the gut but also in other parts of the body, including muscles and joints. This phenomenon is also seen in other chronic pain conditions, such as fibromyalgia, which often coexists with irritable bowel syndrome. Patients with irritable bowel syndrome may thus experience widespread musculoskeletal pain, often in the form of generalized aches, fatigue, or specific areas of tenderness.

2. Inflammatory and immune factors

Some studies suggest that low-grade inflammation and immune system dysregulation in irritable bowel syndrome can contribute to musculoskeletal pain. While irritable bowel syndrome is generally considered a non-inflammatory condition, research has shown that patients with irritable bowel syndrome may have subtle immune changes and increased levels of inflammatory markers, which could impact musculoskeletal tissues and lead to pain and stiffness.

3. Visceral-somatic pain crossover

Visceral pain, or pain originating from internal organs like the intestines, can sometimes lead to somatic pain, which affects muscles and joints. The nervous system may interpret signals from irritated or inflamed gut regions as pain in musculoskeletal areas, a phenomenon known as visceral-somatic convergence. This crossover can cause irritable bowel syndrome patients to feel musculoskeletal discomfort or pain in areas like the lower back, hips, and even shoulders.

4. Psychological stress and pain perception

Psychological factors play a significant role in both irritable bowel syndrome and chronic musculoskeletal pain. Anxiety, depression, and chronic stress can amplify pain perception through the brain-gut axis, a bidirectional communication system between the brain and the gastrointestinal system. This connection means that stress and psychological distress can worsen both irritable bowel syndrome symptoms and musculoskeletal pain, creating a cycle of chronic discomfort. This mechanism is further supported by studies showing that cognitive-behavioral therapy and other stress-relief techniques can reduce symptoms of both irritable bowel syndrome and chronic pain.

5. Overlap with other chronic pain syndromes

irritable bowel syndrome often coexists with other chronic pain syndromes, such as fibromyalgia, chronic fatigue syndrome, and temporomandibular joint disorders. These conditions share common mechanisms, such as central sensitization and dysregulation of pain processing, which may contribute to both gastrointestinal and musculoskeletal symptoms. This overlap suggests that patients with irritable bowel syndrome may be more susceptible to developing musculoskeletal pain due to underlying shared pain mechanisms.