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Fibromyalgia

Expert reviewer, Dr Sundeept Bhalara, Consultant Rheumatologist and General Physician
Next review due January 2025

Fibromyalgia is a long-term (chronic) condition that’s associated with pain in different places in your body. You may also have trouble sleeping, feel tired, and have problems with your memory.

There’s no cure for fibromyalgia, but there are lots of ways to manage the condition and help ease your symptoms.

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About fibromyalgia

In fibromyalgia, there seems to be a problem with the way your brain and nervous system process pain. This means that you feel pain all around your body, even when there isn’t any damage to your muscles or other tissues. Although there may not seem to be any obvious reason for your pain, the pain you feel is still very real. The same changes in your brain that affect how you process pain can also affect your memory, mood, and sleep patterns too.

Fibromyalgia is a common condition which is thought to affect up to one in 20 people. It’s much more common in women than in men. Most people with fibromyalgia start to get symptoms between the ages of 20 and 60. You’re more likely to get it as you get older, but children can get it too.

Causes of fibromyalgia

It’s not clear exactly why some people develop fibromyalgia, but there are certain factors that seem to increase your risk.

Fibromyalgia runs in families. You’re more likely to get fibromyalgia at some time in your life if one of your relatives has it. It’s linked to other chronic pain disorders too, such as irritable bowel syndrome (IBS) and temporomandibular joint disorder. So, if you or someone in your family has one of these conditions, you may be more likely to get fibromyalgia.

It’s thought that certain things may trigger symptoms of fibromyalgia. These can include traumatic events, such as a car crash, having major surgery, or having an infection.

Sleep problems may also play a role in triggering fibromyalgia symptoms. Lack of sleep can affect nerve pathways that control pain, making your symptoms worse.

Fibromyalgia symptoms

The main symptoms of fibromyalgia include:

  • widespread pain in your body, often affecting your neck and shoulders, or lower back
  • oversensitivity to touch, light, sounds or smells – even a slight touch may seem painful
  • feeling stiff, especially when you wake up – it may get worse when you move
  • feeling very tired and lacking energy
  • sleeping badly and waking up unrefreshed
  • problems with your memory or thinking clearly (sometimes called ‘fibro fog’)
  • changes in your mood
  • getting ‘pins and needles’ or tingling feelings
  • headaches

These symptoms may get worse in cold weather or if you’re feeling stressed. If you’re getting these symptoms on a regular basis, contact your GP for advice.

Other health conditions can be associated with fibromyalgia. These include:

Nearly one in three people who are diagnosed with fibromyalgia have symptoms of depression. If you’re finding it difficult to manage pain, or lack of sleep, this can make you feel depressed. It’s also possible that fibromyalgia and depression can come about in the same way – through changes to chemicals in your brain.

Diagnosis of fibromyalgia

Your GP will usually be able to diagnose fibromyalgia based on your symptoms, and by ruling out other potential causes for your pain. They’ll ask you about your symptoms, your general health, and your medical and family history. They may go through different parts of your body, to check exactly where you’re getting pain. Your GP may also ask you how severe other symptoms are, including tiredness, sleep problems and memory problems. The more parts of the body that are affected and the more severe your symptoms are, the more likely you are to have fibromyalgia.

Your GP will also examine you to check for signs of other conditions that could be causing your pain.

There’s no specific fibromyalgia test. But your GP may do some blood tests to rule out other conditions with similar symptoms to fibromyalgia.

Sometimes, your GP may refer you to a specialist for further tests or treatment. These may include one or more of the following.

  • A pain specialist, often based in a pain clinic.
  • A musculoskeletal (MSK) specialist, such as a physiotherapist or MSK physician (health professionals who specialise in treating conditions that affect muscles and joints).
  • A rheumatologist (a doctor who specialises in identifying and treating conditions that affect the muscles and joints).
  • A psychologist (a doctor who specialises in mental health and psychological treatments).

Self-help for fibromylagia

A big part of managing fibromyalgia is learning to understand your condition and what you can do to help yourself. Different things work for different people. But the following tips may help.

  • Learn about fibromyalgia and the ways you can manage it. It may help to share this information with your family and friends so they can support you.
  • Pace yourself. Work within your limits and break up tasks into smaller sections if that helps.
  • Do some exercise every day if you can, even if it’s just a little. See our treatment section below for more information about exercise for fibromyalgia.
  • Try to get into a good sleep routine to help with your tiredness.
  • Learn some relaxation techniques. Try to do something you find relaxing each day, especially before bedtime.
  • Having a hot bath or applying heat with a hot water bottle may help ease pain and stiffness.
  • Practising mindfulness may help.
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Treatment of fibromyalgia

There isn’t a cure for fibromyalgia, but there are treatments and things you can do that can help ease your symptoms. Often a number of health professionals will be involved in your care, and your treatment will involve a combination of different therapies. As you get to understand your condition better, you can work together with your doctors and therapists to find the best treatments for you.

Exercise

Keeping active with regular exercise can be really helpful for people with fibromyalgia. It can help relieve pain and stiffness, increase your strength and improve how easily you move around. It can improve general wellbeing too.

Aim to do some exercise every day, incorporating the following types.

  • Aerobic exercise – activity that gets you breathing harder and faster.
  • Resistance (strengthening) exercise – to strengthen muscles and protect joints.
  • Stretching exercises – to increase flexibility.

Your doctor or physiotherapist may advise you on exercises for fibromyalgia and how to exercise safely and effectively. They may recommend an exercise programme for you. It’s usually best to start slowly, gradually building up the time you spend being active each day. Walking or water-based exercises are both good forms of exercise to start with. Be patient – you may find your pain and tiredness get worse at first but they should improve.

Other activities that combine exercise and relaxation, like yoga and t’ai chi, might also help with some of the symptoms of fibromyalgia.

Talking therapies

Your doctor may recommend a talking therapy called cognitive behavioural therapy (CBT). It helps to challenge negative thoughts, feelings and behaviours, and how you manage pain. You may be able to see a CBT therapist or access the treatment online.

Complementary therapies

Your doctor may suggest trying a course of acupuncture to see if this helps your symptoms. Acupuncture involves using fine needles inserted into specific areas of your body to relieve pain. It should be delivered by a health professional with appropriate training in the therapy.

There isn’t enough evidence to support use of other therapies for fibromyalgia, such as transcutaneous electrical nerve stimulation (TENS) machines or ultrasound.

Medicines

Doctors will usually recommend focusing on other treatments before suggesting medicines for fibromyalgia. This seems to be better for managing fibromyalgia symptoms long term, and avoiding dependence on medicines. However, if you’ve tried other options for managing your symptoms, your doctor may offer you treatment with an antidepressant. Antidepressants are often used to help with sleep problems and pain, even if you don’t have depression.

Other types of medicine have previously been used in the treatment of fibromyalgia, including non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol, opioids and medicines for epilepsy. If you’re already taking one of these medicines for fibromyalgia, your doctor may talk to you about whether or not to continue with them.

Living with fibromyalgia

It can be difficult to stay positive when you’re in pain and feeling tired. Having long-term pain can make you feel isolated and lower your mood. Staying connected with friends and family can help. You could also consider joining a support group. Ask your GP practice if they know any local to you, or check the organisations listed below under ‘Other helpful websites’.

If you’re finding work challenging because of your pain or tiredness, talk to your employer to discuss your options. Work can be a good thing for many reasons, such as keeping up your physical abilities, self-esteem, confidence, and social relationships. It’s worth looking into whether you can make some changes that can allow you to keep working. You may be able to make some adaptations to your workplace. Or you may be able to work flexible hours or have additional rest breaks to cope with fatigue. An occupational health adviser or therapist may be able to help you with this.

If you’re not working, it’s a good idea to build other things into your life, such as taking up a new hobby. This could be a distraction from the pain of your condition and can help you to keep active and expand your social life.

Frequently asked questions

  • Fibromyalgia runs in families so it may be linked to your genetic make-up. You’re more likely to get fibromyalgia at some time in your life if one of your relatives has it.

    It’s possible that experiencing a traumatic event, such as a car crash or serious illness may also trigger fibromyalgia. See our Causes section for more information.

  • There isn’t a specific test for fibromyalgia. Instead, your doctor will usually be able to diagnose it by asking about your symptoms. They’ll want to know which parts of your body are affected and how severe they are. They may do some blood tests to rule out other conditions. You can find out more in our Diagnosis section.

  • Fibromyalgia won’t go away, but there are various therapies and things you can do to help ease your symptoms. Keeping active with regular exercise is an important part of managing fibromyalgia symptoms. Getting good control of your fibromyalgia will allow you to manage your symptoms and live a full life.

  • With fibromyalgia, you have widespread pain affecting different parts of your body. Many people have problems with sleep too. You may feel very tired and not have much energy. See our Symptoms section for more details.



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Related information

  • Discover other helpful health information websites.

    • Fibromyalgia. Patient. patient.info, last edited 21 July 2021
    • Fibromyalgia. BMJ Best Practice. bestpractice.bmj.com, last reviewed 16 November 2021
    • Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain. National Institute for Health and Care Excellence (NICE). www.nice.org.uk, published 7 April 2021
    • Jones GT, Atzeni F, Beasley M, et al. The prevalence of fibromyalgia in the general population: a comparison of the American College of Rheumatology 1990, 2010, and modified 2010 classification criteria. Arthritis Rheumatol 2015; 67(2):568–75. doi: 10.1002/art.38905
    • Fibromyalgia. MSD Manual. www.msdmanuals.com, last full review/revision February 2020
    • Fatima G, Das SK. Deciphering the role of sleep in fibromyalgia syndrome. J Sleep Med Disord 2016; 3(4):1055
    • Fibromyalgia. Versus Arthritis. www.versusarthritis.org, accessed 17 December 2021
    • Wolfe F, Clauw DJ, Fitzcharles MA, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken) 2010; 62(5):600–10. doi: 10.1002/acr.20140
    • Employee's guide. Fibromyalgia Action UK. www.fmauk.org, published 4 August 2020
  • Reviewed by Pippa Coulter, Freelance Health Editor, January 2022
    Expert reviewer Dr Sundeept Bhalara, Consultant Rheumatologist and General Physician
    Next review due January 2025

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