Fibromyalgia
Also known as Fibromyalgia syndrome, FMS
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is fibromyalgia?
Fibromyalgia causes widespread musculoskeletal pain accompanied by fatigue, unrefreshing sleep and cognitive difficulty. It is understood as a disorder of central pain processing, in which the nervous system amplifies pain signals. Blood tests and scans are normal, which does not mean the pain is imagined. Exercise and sleep are the most effective long term treatments.
Causes
- Central sensitisation with amplified pain signalling
- Altered neurotransmitter levels affecting pain regulation
- Genetic predisposition
- Triggering physical or emotional trauma
- Sleep disturbance perpetuating symptoms
Symptoms
- Widespread pain lasting more than three months
- Fatigue not relieved by rest
- Unrefreshing or disrupted sleep
- Cognitive difficulty often described as fibro fog
- Morning stiffness
- Headaches
- Heightened sensitivity to pressure, cold, light or noise
Risk factors
- Female sex
- Family history of fibromyalgia
- Existing rheumatic disease such as lupus or rheumatoid arthritis
- History of trauma or post traumatic stress
- Chronic sleep disorders
Diagnosis
- Clinical criteria based on widespread pain and symptom severity
- Duration of at least three months
- Blood tests to exclude thyroid disease, inflammatory arthritis and vitamin D deficiency
- Assessment of sleep and mood
- Diagnosis of inclusion rather than pure exclusion
Treatment
- Graded aerobic exercise, which has the strongest evidence
- Sleep hygiene and treatment of coexisting sleep disorders
- Cognitive behavioural therapy and pain management programmes
- Amitriptyline, duloxetine or pregabalin in selected patients
- Education about central sensitisation
- Avoiding long term opioids, which are ineffective and harmful here
Self care
- Build activity gradually and consistently rather than in bursts
- Keep a regular sleep schedule and treat sleep problems
- Pace tasks and avoid the boom and bust cycle
- Use relaxation, mindfulness or breathing techniques
- Stay in work or study with adjustments where possible
- Learn about central sensitisation, which reduces fear of pain
- Avoid long term opioids
When to see a doctor
Book an appointment if:
- Widespread pain lasting more than three months
- New symptoms that do not fit your usual pattern
- Sleep consistently unrefreshing
- Low mood or anxiety developing
- Current treatment no longer helping
- For support with work adjustments
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- No established way to prevent fibromyalgia
- Flares are reduced by consistent sleep, pacing and exercise
- Treat mood and sleep disorders early
- Avoid deconditioning through prolonged rest
Outlook
Fibromyalgia is long term and does not damage joints or shorten life. Symptoms fluctuate, and many people achieve substantial improvement in function through graded exercise, sleep management and pain education, even when pain does not disappear entirely. Outcomes are better when treatment focuses on function rather than on eliminating pain.
Common questions
Is fibromyalgia a real condition if tests are normal?
Yes. Normal blood tests and scans reflect the absence of tissue damage, not the absence of pain. Research consistently shows measurable differences in how the nervous system processes pain signals in fibromyalgia.
Will exercise make the pain worse?
Starting too hard can cause a flare, which is why exercise is introduced gradually. Built up slowly and consistently, aerobic activity is the single most effective long term treatment.
Are strong painkillers useful?
Opioids are not recommended. They do not work well for centrally mediated pain and carry risks of dependence and increased pain sensitivity over time.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.