The pain you really feel, but that doctors can't see, measure or fully explain.

What you feel: Like a Mack truck ran you over, despite night after night of decent sleep. You also may be super-sensitive to loud noises, bright lights and, especially, physical touch (when you're hugged, you recoil in pain...and still hurt 10 minutes later).

What you tried: You’ve been going to sleep earlier, and you talked to your doctor about arthritis.

What it might be: **Fibromyalgia, a disorder best known for the way it makes your muscles ache, even though they appear normal to a doctor's eye, to an X-ray and to a microscope when biopsied. Fibromyalgia patients seem to have issues in their central nervous system that amplify their reaction to pain—"their pain thermometer is set differently," explains Scott Zashin, MD, a board-certified internist and rheumatologist based in Dallas. This flaw in the way the brain perceives pain has recently led experts to classify this illness as a "central sensitization syndrome." While there's a blood test for the disease, it's not commercially available, so this can be tricky to diagnose.

What to do: Make an appointment with a rheumatologist who specializes in these types of disorders and is familiar with the symptoms. Zashin says that there are FDA-approved medications for fibromyalgia, but he'd start by trying to improve the quality of your sleep (through sleep hygiene, dietary changes, aerobic exercise), because sleep deprivation is known to increase sensitivity to pain, even when you're healthy. He might also recommend cognitive behavioral therapy. "Even if we can't make the pain disappear, we can help the patient deal with it and hopefully aggravate it less," he says.

**The explanation for your discomfort could be any number of things, but this is one to bring up with your doctor, who is, of course, the person you should be talking to.


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