Fibromyalgia

Fibromyalgia is a long-term condition that causes widespread musculoskeletal pain, ongoing fatigue and sleep problems. You may also have memory or focus issues, often called “fibro fog.”

Research shows it involves changes in how your central nervous system processes pain. This system becomes more sensitive and amplifies pain signals. This means your body feels pain more strongly.

Symptoms often come and go in periods called flare-ups. There isn’t a cure, but treatment could help manage symptoms.

Fibromyalgia symptoms

Symptoms may feel worse during a flare-up. A flare-up is a period when your symptoms suddenly get stronger or harder to manage. At other times, symptoms may feel milder and easier to handle. Common symptoms include:

• Muscle pain or tenderness
• Face and jaw pain
• Fatigue
• Headaches and migraines
• Digestive problems, like diarrhea and constipation
• Urinary urgency or frequency

Fibromyalgia can cause mental and emotional symptoms, including:

• Memory problems (“fibro fog” or “brain fog”)
• Anxiety
• Depression
• Insomnia and other sleep disorders

What does fibromyalgia feel like?

People commonly describe widespread fibromyalgia pain as:

• Aching
• Burning
• Throbbing
• Hurting all over

Fatigue and sleep problems can make daily life harder. You may have unrestful sleep. This means you wake up feeling tired even after sleeping all night. You might also have trouble falling asleep, staying asleep or waking up refreshed. This can make your day feel long and draining.

Many people also describe feeling “fibro fog” or “brain fog.” This is when you have trouble concentrating, remembering things or thinking clearly.

What causes fibromyalgia?

Experts haven’t found one single cause of fibromyalgia. Many researchers think fibromyalgia affects how your brain and spinal cord (central nervous system) process pain. Your central nervous system becomes more sensitive. This is called central sensitization. It means your body amplifies pain signals, so you feel pain more strongly than expected.

Because experts don’t know the exact cause, there’s no known way to prevent it.

What triggers a fibromyalgia flare-up?

In general, anything that increases stress on your body or mind could trigger a flare-up. Common triggers include:

• Emotional stress
• Changes in your daily routine
• Not getting enough sleep or changing your sleep schedule
• Weather or temperature changes
• Illness or injury
• Starting a new medication or changing your usual treatment plan

Triggers vary from person to person. Something that causes symptoms for someone else may not affect you the same way. Learning your personal triggers may help you plan ahead and manage symptoms more effectively.

Is fibromyalgia hereditary?

Fibromyalgia can run in biological families. This suggests a genetic link. If you have a close family member who has this condition, you have a higher risk of developing it. Researchers continue to study specific genes that may increase risk.

Risk factors

Anyone can develop this condition. You may have an increased risk of developing it if you:

• Are female
• Are an adult
• Have a family history of fibromyalgia
• Have a mood disorder or significant stress
• Have other chronic pain disorders

Children can get fibromyalgia, too, but it's less common than in adults.

Complications of fibromyalgia

Fibromyalgia could lead to other health and life challenges over time. These may include:

• Decreased daily functioning (affecting your ability to walk, work and do your usual activities)
• Higher risk of depression

If you’re struggling physically or emotionally, talk with your healthcare provider. Support and treatment are available.

How is fibromyalgia diagnosed?

A healthcare provider diagnoses fibromyalgia based on your symptoms, medical history and a physical exam. During the exam, they’ll check for tenderness in different areas of your body.

Your provider may order basic blood tests to rule out other conditions, like thyroid disease or inflammatory arthritis. Lab tests help rule out other causes.

There isn’t a single blood test or scan that confirms fibromyalgia. The blood tests that you may see advertised for this condition aren’t accurate enough for most people. For that reason, insurance often doesn't cover them.

Fibromyalgia diagnostic criteria

Many healthcare providers use the American College of Rheumatology diagnostic criteria to make a diagnosis. You must have:

• Widespread pain in at least four out of five body regions
• Symptoms that last at least three months
• No other condition that fully explains the pain

Your provider may also use symptom scoring tools. These measure:

• How many areas of your body hurt (Widespread Pain Index or WPI)
• How severe your fatigue, sleep problems and thinking difficulties are (symptom severity score or SS)

Fibromyalgia treatments

There are different treatment options available to manage symptoms. You may need to try a combination of lifestyle changes, medications and therapies to find what works best.

Your healthcare provider might recommend the following as a first line of treatment:

• Regular low-impact exercise, like walking, swimming, biking or yoga
• Good sleep habits, like keeping a regular bedtime and limiting screen time before bed
• Stress reduction techniques, like mindfulness, relaxation exercises or meditation

Fibromyalgia medication

If symptoms are moderate to severe, your provider may recommend medication, including:

• SNRIs: These may help with pain and mood.
• Tricyclic antidepressants: These may improve sleep and manage pain.
• Antiseizure medications: These may reduce nerve-related pain.
• Central-acting analgesics: These may block pain signals in your brain and spinal cord.

Fibromyalgia therapies

Several therapies may help manage this condition alongside other treatment options. Your provider may recommend:

• Mental health support: This helps you manage pain, stress and negative thought patterns. Cognitive behavioral therapy is an example of such support.
• Physical therapy: Gentle stretching and strengthening exercises may improve movement, reduce pain and build stamina.
• Sleep programs: These focus on improving your sleep habits and routines.
• Complementary therapies: These may relax muscles, reduce pain signals and improve overall comfort. Examples of therapies include acupuncture, massage therapy, hypnosis, biofeedback, heat therapy and TENS.

Your provider can help you decide which therapies may work best for you.

How to calm a fibromyalgia flare-up

When a flare-up happens, focus on small, steady steps. The goal is to calm symptoms without stopping all activity. Try to:

• Pace your activity: Avoid overdoing it, but don’t stay in bed all day. Try gentle stretching or light movement and slowly return to your routine.
• Protect your sleep: Keep your room dark and quiet at bedtime. Avoid screens or caffeine before bed.
• Lower stress: Practice deep breathing, meditation, mindfulness or other relaxation techniques.
• Use supportive therapies: Heat therapy, gentle massage or stretching may help.
• Stay consistent with treatment: Take medications as prescribed. Contact your provider if symptoms don’t improve.

What are the four stages of treating fibromyalgia?

Sometimes, healthcare providers talk about treatment in “stages.” These aren’t strict steps. They’re general areas of care that help manage symptoms. This condition doesn’t follow a set pattern. Symptoms don’t happen in a certain order, and everyone’s experience is different.

The four main parts of treatment include:

1. Non-medication treatments: Stretching and exercise can help loosen and strengthen muscles and joints.
2. Mental health support: Therapy can help you cope with stress and protect your emotional well-being.
3. Medications: Medicines can help manage pain, sleep problems or mood symptoms.
4. Daily functioning support: A therapist can help you adjust your routine if symptoms make daily tasks harder.

Your provider will tailor treatment to how you feel, your physical function and what you need at different times.

What can I expect if I have fibromyalgia?

Fibromyalgia is a real condition that has a real impact on your life. It doesn’t damage your joints or organs, and it isn’t life-threatening. But it’s long-term, and it can affect your daily life.

You can expect symptoms to come and go. Some days, you might function fairly well. Other days, even simple tasks might feel draining. The unpredictability might feel frustrating.

This condition can also affect your mood. Living with ongoing pain and fatigue may feel isolating at times. It’s common to feel anxious or down. Know that support is available.

Can fibromyalgia be cured?

There isn’t a cure available right now. But fibromyalgia is treatable. Many people learn ways to manage their energy, improve sleep and reduce stress. In some cases, symptoms may reduce over time.