Fibromyalgia

It's not fully understood why some people develop fibromyalgia. There's no single known cause, and doctors believe several factors usually act together.

Altered pain signals

Your brain, nerves and spinal cord together form your central nervous system. When this system changes the way it sends and receives signals from the rest of your body, it may lead to fibromyalgia.

Fibromyalgia is considered a type of chronic (long-term) pain.

Genetics

Some people are more prone to fibromyalgia than others because of the genes they inherit from their parents.

Triggers

Fibromyalgia often begins after a stressful event, which could be physically demanding on the body or emotionally difficult to cope with.

Possible triggers include:

• an injury
• a viral infection
• childbirth
• a surgical operation
• the end of a relationship
• being in an abusive relationship
• the loss of a loved one

Sometimes, though, there is no clear trigger at all.

Diagnosing fibromyalgia can take time, since there is no single test that can confirm it.

The symptoms of fibromyalgia vary from person to person, and they can look a lot like symptoms of several other conditions. Because of this, your GP will need to rule out other possible causes first.

You will be asked how your symptoms are affecting your day-to-day life, and you will be examined to check for signs of other conditions. Your doctor will look for swollen joints, since this points more towards arthritis than fibromyalgia.

To check for other conditions, you may have urine and blood tests, along with X-rays or other scans. If these tests show that you have another condition, it does not rule out fibromyalgia. It is possible to have both at the same time.

Criteria for diagnosing fibromyalgia

For fibromyalgia to be diagnosed, certain criteria usually need to be met. The most widely used criteria are:

• pain in multiple areas of your body
• symptoms that have stayed at a similar level for at least 3 months
• symptoms that cannot be explained by any other reason
• feeling unrefreshed after sleep
• problems with thinking or memory, known as cognitive difficulties
• fatigue

Diagnosing other conditions

It is also possible to have other conditions alongside fibromyalgia, such as:

• depression
• anxiety
• irritable bowel syndrome (IBS)
• osteoarthritis
• hypermobility spectrum disorder

Identifying all of these conditions together helps your doctor plan the right treatment for you.

Fibromyalgia stays with you over the long term.

There's no outright cure for it, but treatment can ease many of the symptoms and make daily life more manageable. Pain medicines on their own don't always work well for fibromyalgia. What tends to help most is understanding your condition and working out which self management approaches suit you best. A healthcare professional can talk you through the options.

Exercise, movement and activity

Staying active and moving your body regularly can genuinely help with pain.

A physiotherapist can teach you self management skills that lessen the effect pain has on your life. They can work with you to build an exercise plan that fits your needs, abilities and goals.

Physiotherapy can also stop further loss of strength and build up your fitness over time.

Pain management movement videos

For more on exercise and relaxation techniques, see the page on living with chronic pain.

Occupational therapy can help you handle everyday tasks despite fibromyalgia, without making your pain worse or leaving you overwhelmed.

Your occupational therapist may suggest different ways of doing things and can help you keep working, if that is something you want.

Access to Work has information on how to get or stay in work if you have a health condition or disability.

Group support

Some pain clinics run pain management programmes led by a team of specialists, including physiotherapists and psychologists. They help you build coping skills and manage how much you take on.

Talk to your GP if you feel a pain management programme could help you.

Talking therapies

Talking therapies can ease the stress of living with fibromyalgia.

Examples include:

• cognitive behavioural therapy (CBT), which helps you understand how your thoughts and actions are connected
• acceptance and commitment therapy (ACT), often used for pain management

Medication

Medicines cannot cure fibromyalgia, but they can ease some symptoms. Ask your GP or a pain specialist about the possible benefits and risks.

Your GP will usually suggest exercise, CBT and physiotherapy before anything else, since these tend to help more.

Antidepressants ease pain and improve sleep problems for some people with fibromyalgia. They can be worth trying even if you have not been diagnosed with depression.

Other medicines are sometimes used for fibromyalgia symptoms too, though they tend to work less well.

If you are on medication and feel it is not helping, talk to your GP, pharmacist or another healthcare professional.

Alternative therapies

Some people with fibromyalgia try complementary or alternative treatments such as acupuncture or massage.

There is little scientific proof that these help in the long run, though some people find they bring relaxation and less stress, which makes coping with the condition easier.

If you are thinking about complementary or herbal remedies and have any concerns, check with your local pharmacist or a healthcare professional first, since some remedies can react unpredictably with other medicines or make them less effective.

Read more about herbal medicines.

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