Article featured on Brigham’s and Women’s Hospital
Fibromyalgia is a chronic condition characterized by widespread pain in muscles and soft tissues throughout the body. It often brings fatigue, sleep disturbances, and cognitive challenges known as “fibro fog.” Although the exact cause remains unclear, researchers link it to stress, sleep issues, and possible biochemical or immune factors. While there’s no cure, a combination of medical treatments, exercise, and lifestyle changes can help manage symptoms and improve quality of life. Understanding fibromyalgia is the first step toward taking control of the condition.
What is fibromyalgia?
Fibromyalgia is a condition that causes pain in muscles and soft tissues all over the body. It is an ongoing (chronic) condition. It can affect your neck, shoulders, back, chest, hips, buttocks, arms, and legs. The pain may be worse in the morning and evening. Sometimes, the pain may last all day long. The pain may get worse with activity, cold or damp weather, anxiety, and stress. This condition is more often diagnosed in people between the ages of 20 and 50. It is most common in middle-aged women.
What causes fibromyalgia?
The cause is unknown. Researchers think there may be a link with sleep problems and stress. It may also be linked to immune, endocrine, or biochemical problems.
What are the symptoms of fibromyalgia?
Each person’s symptoms may vary. But chronic pain is the most common symptom. The pain most often affects the muscles and the points where muscles attach to bones. These are the ligaments and tendons.
Pain may start in 1 part of your body, such as your neck and shoulders. But any part of the body may be affected. The pain ranges from mild to severe, with “flare ups” and times of improvement. The discomfort from fibromyalgia may feel like burning, soreness, stiffness, aching, or gnawing pain, often times with sore spots in certain parts of your muscles. The pain may feel like arthritis. But it doesn’t damage muscles or bones.
Other common symptoms of fibromyalgia include:
- Medium to severe tiredness (fatigue)
- Less exercise endurance
- Sleep problems at night
- Depressed mood
- Anxiety
- Headaches
- Irritable bowel symptoms, such as belly (abdominal) pain and bloating, diarrhea, and constipation
- Restless legs
- Painful menstrual periods
- Trouble thinking clearly (called “fibro fog”)
These symptoms can seem like other health conditions. Make sure to see your healthcare provider for a diagnosis.
How is fibromyalgia diagnosed?
There are no tests that can confirm a diagnosis of fibromyalgia. Instead, diagnosis is based on your symptoms, a physical exam, and possibly ruling out other conditions.
How is fibromyalgia treated?
Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.
There is no known cure for fibromyalgia, but symptoms can be managed. Mild cases may get better with stress reduction or lifestyle changes. More severe cases may need to be treated with a healthcare team approach. This may include your primary healthcare provider, a specialist called a rheumatologist, a physical therapist, and a pain management clinic. Treatment may include:
- Anti-inflammatory medicines to ease pain and help you sleep
- Other pain medicines
- Medicines approved for treating fibromyalgia (duloxetine, pregabalin, and milnacipran)
- Medicines to ease depression (antidepressants)
- Exercise (low impact) and physical therapy to stretch muscles and improve cardiovascular fitness
- Relaxation methods or cognitive behavioral therapy
- Heat or cold treatments
- Alternative treatments, such as acupuncture and chiropractic or massage therapy
Talk with your healthcare providers about the risks, benefits, and possible side effects of all medicines.
Living with fibromyalgia
Fibromyalgia is a chronic condition, but it may be managed by working with your healthcare providers. In addition to medicines, lifestyle changes can help symptoms. These include getting enough sleep and exercise.
When should I call my healthcare provider?
If your symptoms get worse or you have new symptoms, tell your healthcare provider.
Key points about fibromyalgia
- Fibromyalgia is a chronic condition that causes pain in muscles and soft tissues all over the body.
- Researchers think it may be linked to sleep problems, stress, or immune, endocrine, or biochemical problems.
- Symptoms may also include lack of energy (fatigue), sleep problems, depression, headaches, and other problems.
- There is no known cure, but symptoms can be managed.
- Treatments may include medicine, exercise, relaxation, heat or cold, and massage.
Next steps
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
