Fibromyalgia

What is fibromyalgia?

Fibromyalgia is a long-term (chronic) health condition that causes pain and tenderness throughout your body. It causes musculoskeletal pain and fatigue.

People with fibromyalgia usually experience symptoms that come and go in periods called flare-ups. Sometimes, it can feel exhausting and challenging to navigate living with fibromyalgia. The peaks and valleys between feeling good and suddenly having a flare-up of symptoms can feel overwhelming. Fibromyalgia is real, and so is how you feel.

Experts don’t know what causes fibromyalgia, but studies have found that certain health conditions, stress and other changes in your life might trigger it. You might be more likely to develop fibromyalgia if one of your biological parents has it.

Any new pain in your body is often the first sign of fibromyalgia — especially in your muscles. Trust your instincts and listen to your body. Visit a healthcare provider if you’re experiencing new pain, fatigue and other symptoms — even if it feels like they come and go.

Who is affected by fibromyalgia?

Anyone can develop fibromyalgia. It affects people of any age, including children. Around 4 million people in the U.S. are living with fibromyalgia.

People assigned female at birth (AFAB) and people older than 40 are more likely to be diagnosed with fibromyalgia.

What are fibromyalgia symptoms?

The two most common symptoms of fibromyalgia are pain and fatigue. You may experience:

• Muscle pain or tenderness.
• Fatigue.
• Face and jaw pain (temporomandibular joint disorders).
• Headaches and migraines.
• Digestive problems, including diarrhea and constipation.
• Bladder control issues.

Fibromyalgia can cause mental and emotional symptoms, including:

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

What causes fibromyalgia?

Experts don’t know what causes fibromyalgia.

Certain genes you inherit from you biological parents might make you more likely to develop fibromyalgia. Studies have found a link between biological parents who have fibromyalgia and their children — this might mean it’s passed down through families.

People with fibromyalgia are usually more sensitive to pain than most people. Experts haven’t found the direct link yet, but they think genetic mutations in the genes responsible for forming the neurotransmitters in your brain that broadcast and receive pain signals to your body might cause fibromyalgia.

What are the risk factors for fibromyalgia?

Even though experts can’t say for sure what causes fibromyalgia, some health conditions and other issues are risk factors for developing it. Fibromyalgia risk factors include:

• Your age: People older than 40 are more likely to develop fibromyalgia. But it can affect anyone, including children.
• Your sex assigned at birth: People assigned female at birth are twice as likely to experience fibromyalgia.
• Chronic illnesses: People with conditions like osteoarthritis, depression, anxiety disorders, chronic back pain and irritable bowel syndrome are more likely to develop fibromyalgia.
• Infections: Some people develop fibromyalgia after having an infection, especially if they experience severe symptoms.
• Stress: The amount of stress you experience can’t be measured on a test, but too much stress can affect your health.
• Traumas: People who’ve experienced a physical or emotional trauma or a serious injury sometimes develop fibromyalgia.

What triggers a fibromyalgia flare-up?

Certain events or changes in your life can trigger a fibromyalgia flare-up. Everyone is different, and what triggers symptoms for some people might not for you. In general, anything that increases your stress can trigger a flare-up, including:

• Emotional stress caused by your job, financial situation or social life.
• Changes in your daily routine.
• Changes in your diet or not getting enough nutrition.
• Hormone changes.
• Not getting enough sleep or changing when you sleep.
• Weather or temperature changes.
• Getting sick.
• Starting new medication or treatments, or changing something in your usual fibromyalgia treatment routine.

How is fibromyalgia diagnosed?

A healthcare provider will diagnose fibromyalgia with a physical exam and discussion of your health history. They’ll ask about your symptoms and when you first noticed them.

There’s no test that can diagnose fibromyalgia. Usually, diagnosing it is part of a differential diagnosis — a medical process of elimination. Your provider will make a diagnosis by comparing several conditions with related symptoms. This process leads to your final diagnosis.

Your provider might use blood tests to rule out other common causes of fatigue like anemia or issues with your thyroid gland.

How is fibromyalgia treated?

There isn’t a single treatment that works for every person with fibromyalgia. Your provider will work with you to find a combination of treatments that relieve your symptoms. Tell your provider which symptoms you’re experiencing and when they change (including when they’re improving or getting worse).

Treatments you might need include:

• Over-the-counter (OTC) or prescription medicine to relieve pain.
• Exercises like stretches or strength training.
• Sleep therapy.
• Cognitive behavioral therapy.
• Stress management therapy.
• Antidepressants.

What are the four stages of fibromyalgia?

Fibromyalgia is a dynamic condition. This means you won’t experience symptoms in any specific order — there’s no roadmap to know when or how fibromyalgia symptoms will affect you.

Your provider might treat your fibromyalgia in stages based on how you feel. These stages aren’t a step-by-step treatment plan. Every person is different, and how fibromyalgia affects your body will be unique. The stages are more like loose categories that can help you understand which treatments you’ll need to manage your symptoms. The four stages of treating fibromyalgia include:

• Non-pharmacological treatments: Your provider or a physical therapist will give you stretches and exercises to loosen, relax and strengthen your muscles and joints.
• Psychological treatments: A mental health professional will help you identify ways to maintain a healthy self-image. They’ll suggest strategies to manage symptoms that affect your mental and emotional health.
• Pharmacological treatment: Taking medicine to manage your symptoms.
• Daily functioning: An occupational therapist can help you navigate your daily routine if you’re experiencing severe symptoms that make it hard to participate in your regular activities.

How can I prevent fibromyalgia?

Because experts don’t know what causes fibromyalgia, you can’t prevent it.

Maintaining your overall health can help reduce the severity of fibromyalgia symptoms:

• Manage stress as well as you can.
• Follow a diet and exercise plan that’s healthy for you.
• Get enough sleep and practice good sleep hygiene.

What can I expect if I have fibromyalgia?

You should expect to manage fibromyalgia symptoms for a long time — maybe for the rest of your life. Some people with fibromyalgia experience fewer flare-ups with milder symptoms after they find treatments that work for them. Ask your provider how often you need follow-up appointments to adjust your treatments or to adjust any medications you’re taking.

Fibromyalgia is a real condition that has a real impact on your life. Some days it might feel like “it’s all in your head,” but it’s not. Talk to your provider or a mental health professional if you need help managing stress and other emotional symptoms.

What are the complications of fibromyalgia?

People with fibromyalgia are more likely to be hospitalized because of pain, fatigue or mental health symptoms. You’re also more likely to experience memory problems and have trouble concentrating.

Talk to your provider as soon as you notice any changes in your symptoms, especially if you feel like they’re affecting your memory or mental health.

When should I see my healthcare provider?

Visit a healthcare provider if you’re experiencing new symptoms like pain, fatigue or changes in your mental health, including:

• Depression or suicidal thoughts.
• Headaches or migraines.
• Memory problems or you feel like your brain is “foggy.”
• Sleep problems.

What questions should I ask my doctor?

• Do I have fibromyalgia or another condition?
• Which tests will I need?
• Which treatments will work best for me?
• How often will I need follow-up appointments to adjust my treatments?
• Should I work with a mental health professional?
• Does this mean my family members are more likely to develop fibromyalgia?

A note from Cleveland Clinic

Fibromyalgia causes pain all throughout your body. It can also make you feel fatigued and like your mind is clouded by a fog. There’s no cure for fibromyalgia, but your healthcare provider will help you find a combination of treatments that relieve your symptoms.

Even though experts don’t know what causes fibromyalgia, it’s real — and so are your symptoms. They might come and go or be hard to describe, but how you feel is valid and important. Living with a chronic condition like fibromyalgia can be a challenge, but you don’t have to do it alone. Talk to your provider or a mental health professional about managing stress and maintaining a positive self-image.