Fibromyalgia

Fibromyalgia is a chronic condition that causes widespread pain. It affects 2-4% of people, usually women. People who have other 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 signs on x-rays or blood tests. There is currently no cure for fibromyalgia. Medications, exercise, and therapy help.

What Are the Signs/Symptoms?

Fibromyalgia symptoms are different for each person. The most common symptom is widespread pain. 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
• Digestive problems like IBS or heartburn
• Irritable or overactive bladder
• Pelvic pain
• Jaw pain

Blood tests and x-rays may be used to rule out other causes, like thyroid problems or polymyalgia rheumatica.

What Are Common Treatments?

Exercise is the most effective treatment, including yoga, tai chi, or other low-impact aerobic activity. Acupuncture, chiropractic, and massage may help ease symptoms. Psychotherapy may help patients 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 involved in pain. Older drugs, such as amitryptiline (Elavil), cyclobenzaprine (Flexeril) and other antidepressants may be used 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, along with medications, can help reduce pain, improve sleep, and ease fatigue. Exercise often but be gentle with yourself as you are starting. Walking, swimming, stretching, and yoga are good for people with fibromyalgia. Add more movement to daily routines, like taking a flight of stairs instead of the elevator. Rest and relaxation are helpful too. Make time to relax each day. Deep breathing or medication can ease stress. Set regular sleep habits, like going to bed at the same time each night.

Updated February 2023 by Karmela Chan, MD, 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.