Fibromyalgia

Overview

Fibromyalgia is a condition that causes widespread pain all over the body, along with extreme tiredness (fatigue), sleep problems, and sometimes trouble thinking clearly (often called 'fibro fog'). It is not a form of arthritis, but it can feel similar.

Yes, fibromyalgia is common. About 1 in 20 people worldwide may have it. It affects people of all ages, though it is most often diagnosed in middle-aged adults.

Fibromyalgia affects women more often than men, but men and children can also have it. It can start at any age, including in childhood or later in life. People with certain other conditions like rheumatoid arthritis or lupus may be more likely to have fibromyalgia.

Symptoms

Common symptoms

• Widespread pain throughout your body, often described as a dull ache
• Extreme tiredness that does not get better with rest
• Trouble sleeping or waking up feeling unrefreshed
• 'Fibro fog' – problems with memory, concentration, or paying attention
• Increased sensitivity to touch, cold, heat, or bright lights
• Headaches (including tension or migraine-type)
• Irritable bowel syndrome (IBS) with stomach pain, bloating, or changes in bowel habits
• Numbness or tingling in the hands or feet

Symptoms in children

• Children may have widespread muscle and joint pain, often mistaken for growing pains
• They are often very tired and may have trouble sleeping
• Some children feel anxious, sad, or irritable because of constant discomfort

Symptoms in older adults

• Pain and stiffness may be worse in the morning and overlap with arthritis or osteoarthritis
• Fatigue can make daily tasks harder and increase the risk of falls
• Older adults may be more likely to have depression or anxiety related to the condition

Causes

Main causes

• The exact cause is not fully understood, but fibromyalgia is believed to involve problems with how your brain and nervous system process pain signals.
• Possible triggers include a physical injury, an infection (like the flu or COVID-19), or an emotionally stressful event.
• Genetics may play a role – fibromyalgia sometimes runs in families.

Risk factors

• Being female – women are about twice as likely as men to develop fibromyalgia
• Having a family member with fibromyalgia
• Having another chronic condition like rheumatoid arthritis, lupus, or ankylosing spondylitis
• Experiencing a traumatic physical or emotional event, such as a car accident or abuse
• Age – most people are diagnosed between 30 and 55 years old

When to see a doctor

See a doctor urgently if:

• If you experience any new or sudden symptoms that could indicate a medical emergency, such as chest pain, difficulty breathing, or severe head pain
• If you are feeling so low that you think about harming yourself

Book a routine appointment if:

• Make an appointment if you have had widespread pain for more than three months, especially with extreme fatigue or sleep problems
• If your symptoms are affecting your daily life, work, or relationships

Diagnosis

There is no single lab test for fibromyalgia. Your doctor will ask about your symptoms (pain, fatigue, sleep, thinking) and do a physical exam. They will also check for other conditions that could cause similar symptoms, such as rheumatoid arthritis or thyroid problems.

Tests that may be done

• Blood tests to rule out other conditions (for example, complete blood count, thyroid function, inflammation markers like ESR and C-reactive protein)
• Your doctor may ask you to complete a symptom questionnaire
• If needed, your doctor may refer you to a rheumatologist (a doctor who treats conditions that affect joints and muscles)

What to expect at your appointment

The diagnosis process may take a few visits. Your doctor will listen carefully to your story and perform a physical exam. They may press on certain tender points to check for widespread tenderness. It can help to keep a symptom diary to share with your doctor. Remember, fibromyalgia is a real condition, and with the right plan, you can manage it.

Treatment

Treatment for fibromyalgia focuses on relieving your symptoms and improving your quality of life. There is no one-size-fits-all approach, so your plan may include a combination of self-care, lifestyle changes, talking therapies, and medicines. The goal is to help you feel better and stay active.

Self-care at home

• Gentle, regular exercise like walking, swimming, or yoga can help reduce pain and fatigue
• Establish a consistent sleep routine – go to bed and wake up at the same time each day
• Practice stress management techniques such as deep breathing, meditation, or mindfulness
• Pace yourself – break tasks into smaller steps and take breaks before you get too tired

Medical treatments

Doctors may recommend certain medicines to help manage pain, improve sleep, or lift your mood. These can include pain relievers, antidepressants that also help with nerve pain, or medicines for sleep problems. Physical therapy, occupational therapy, and cognitive behavioural therapy (CBT) are also very helpful. Always talk to your healthcare provider about the best treatment choices for you – never start or stop any medicine without their advice.

When is surgery considered?

Surgery is not used to treat fibromyalgia itself. If you have another condition that requires surgery, your care team will take extra steps to manage your fibromyalgia symptoms before and after the procedure.

Living with this condition

Living with fibromyalgia means learning to manage your energy and listen to your body. You may have good days and bad days. It helps to set realistic goals, ask for help when you need it, and focus on what you can do rather than what you cannot.

Lifestyle tips

• Stay active with low-impact exercise – even 10 minutes a day can help
• Eat a balanced diet with lots of fruits, vegetables, and whole grains; avoid processed foods and large amounts of caffeine or sugar
• Get enough rest – aim for 7 to 9 hours of sleep a night, and try to keep a regular sleep schedule
• Find healthy ways to handle stress, such as talking with a friend, listening to music, or spending time in nature

Diet and exercise

There is no special diet for fibromyalgia, but eating a healthy, varied diet can support your overall health. Regular gentle exercise like walking, swimming, or tai chi can reduce pain and stiffness and boost your energy. Start slowly and increase gradually as you feel able.

Mental health and emotional wellbeing

Fibromyalgia can cause frustration, anxiety, and depression because of ongoing pain and fatigue. It is very common to feel down or worried. Talking to a counsellor or therapist trained in cognitive behavioural therapy can help you cope. If you have thoughts of harming yourself, please reach out for help immediately.

Prevention

There is no known way to prevent fibromyalgia because the exact cause is not yet known. However, if you have fibromyalgia, early diagnosis and treatment can help reduce the impact on your life and prevent symptoms from getting worse.

Complications

If left untreated

• Chronic pain and fatigue that can make it hard to work, study, or enjoy time with loved ones
• Higher risk of depression, anxiety, and other mood disorders
• Sleep problems that can worsen other health issues
• Reduced ability to participate in physical and social activities

Long-term outlook

Fibromyalgia is a long-term condition, but many people learn to manage their symptoms well and lead full, active lives. With the right treatment plan – including self-care, support, and medical help – most people feel better over time. There is hope, and you do not have to face it alone.

Find support

International organisations

• Fibromyalgia Association UK ↗
• National Fibromyalgia Association (US) ↗

Local organisations

• NHS Inform (Scotland) ↗ · Scotland
• Fibromyalgia Action UK ↗ · UK

Helplines

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