Q. I have severe pain in spine and lower back with history of fibromyalgia. Please help.

Answered by
Dr. Atul Prakash
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on May 14, 2020

Hello doctor,

For the last month, I have been suffering with pain on my spine and lower back. When I touch a specific point on my spine the pain is severe. It hurts when I bend or sit it feels very sore. I visited a GP and she said that she thinks it is a muscle insertion that causes the pain but she is not sure. She did a neurological examination and all was normal.

I wanted your opinion as my ankles and shin bone now started being painful too. I was diagnosed with fibromyalgia four months ago and wanted to know if it is this that causes bone pain. My posture is quite bad too so I am not sure what it could be. I am very worried in case it is something very serious. What I should do now?



Welcome to

From your history and being unable to examine you I can only speculate on the cause. Yes, fibromyalgia can lead to trigger spots like tender areas which can be over the muscle belly or their attachment on the bone. The good thing was that the neurological exam was normal.

Now coming to your concern that the shin and ankles had become painful. I will recommend that you get your ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), complete blood count (CBC), urine routine, Vitamin D levels, and blood sugar tested.

This will generally show indication about any inflammatory process and bars on that you can be started on antiinflammatory medication including steroids and possibly vitamin D too.

Please let me know your investigation results.

Thank you doctor,

I will do the recommended tests. I am worried in case it is cancer and have lost my sleep over this. Would an x-ray show a bone tumor? Would I experience other symptoms too if it was that? Could shin inflammation or vitamin deficiency cause the pain in my shin, bones, and ankles?



Welcome back to

What made you think on lines of your symptoms possibly being a manifestation of cancer? Are you overthinking this, (sorry but I cannot really answer that) but I can say that things are common and they need to be tested for and only after that I will really consider an alternative possibility.

Are you losing weight? Do you have night sweats? Do you have an altered bowel habit? Is there any redness or swelling over the shin? Are you able to bear weight without aggravation of pain? Does the pain keep you awake at night? If not then let us not worry about things unnecessarily.

Bone tumor are rare condition and yes the best way to diagnose will be clinical exam followed by an x-ray. Shin pain is a common manifestation of vitamin D deficiency.

I hope this helps.

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