Fibromyalgia

Fibromyalgia is a chronic condition that causes widespread pain. It affects 2–4% of people, usually women. People who have other chronic conditions (such as rheumatic diseases) are at higher risk of having fibromyalgia. Fibromyalgia is not an inflammatory or autoimmune disease. Research suggests that the nervous system is involved. Brain chemicals, like serotonin and norepinephrine, may be off balance, changing reactions to painful stimuli. Fibromyalgia may cause fatigue, poor sleep, and mood problems, like anxiety or stress. It does not cause any abnormalities on x-rays or blood tests. There is currently no cure for fibromyalgia. Medications, exercise, and therapy can help.

What Are the Signs/ Symptoms?

Fibromyalgia symptoms are different for each person. The most common symptom is widespread pain in various joints. Severe fatigue and sleep problems are also common. Someone with fibromyalgia may not feel refreshed after sleeping all night. Other fibromyalgia signs and symptoms include

• Problems with memory or clear thinking, known as “fibro fog”
• Depression or anxiety
• Migraines or tension headaches
• Digestion problems like irritable bowel syndrome (constipation or diarrhea) or heartburn
• Urinary issues due to irritable or overactive bladder
• Pelvic pain

Blood tests and x-rays may be useful to check for other causes, like thyroid problems or diseases that are driven by inflammation.

What Are Common Treatments?

Exercise is the most effective treatment: yoga, tai chi, or other low-impact aerobic activity. Acupuncture, chiropractic and massage can help. Psychotherapy may help manage stress and anxiety. A sleep specialist may help patients address sleep disorders. Three drugs are FDA-approved for fibromyalgia: duloxetine (Cymbalta) and milnacipran (Savella) adjust brain chemicals to ease widespread pain, and pregabalin (Lyrica) which blocks overactive nerve cells. Drugs called amitryptiline (Elavil) orcyclobenzaprine (Flexeril) and other antidepressants can help too. Opioids and sleep medicines like zolpidem (Ambien) are not recommended for use in treating fibromyalgia symptoms.

Living with Fibromyalgia

Self-care is important to manage fibromyalgia symptoms and have a good quality of life. A healthy lifestyle can help reduce pain, improve sleep, and ease fatigue. Exercise is recommended but be gentle with yourself as you are starting. Walking, swimming, and especially stretching and yoga are great for people with fibromyalgia. Add more movement to daily routines, like taking a flight of stairs instead of the elevator. Deep breathing, meditation and mindfulness help ease stress. It is recommended to set healthy sleep habits: no eating in the hour prior to bed, going to bed at same time each night, no screens prior to bed. Managing fibromyalgia can be a slow and challenging process. Setting small goals along the way can help you achieve an overall goal of improved activity and healthy lifestyle (sleep, diet, etc.) to most effectively manage symptoms of fibromyalgia.

Updated February 2025 by Pankti Reid, MD, MPH, and reviewed by the American College of Rheumatology Committee on Communications and Marketing.

This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.