Fibromyalgia
Fibromyalgia is a long-term condition that commonly causes widespread pain, persistent fatigue, unrefreshing sleep and difficulties with memory or concentration ("fibro fog"). It results from changes in how the nervous system processes pain rather than damage to muscles or joints. Although there is currently no cure, many people experience significant improvements in symptoms and quality of life through a personalised approach to management.
This information is intended for educational purposes and should not replace professional medical advice. If you have new, severe or worsening symptoms, always seek advice from your GP or specialist healthcare team.
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KEY FACTS
✔ Recognised medical condition
Fibromyalgia is a recognised chronic pain condition affecting how the nervous system processes pain signals.
✔ No tissue damage
It does not damage the joints, muscles or other body tissues, even though the pain can be severe.
✔ Clinical diagnosis
There is currently no single blood test or scan that confirms fibromyalgia. Diagnosis is based on symptoms and clinical assessment.
✔ Symptoms fluctuate
Most people experience periods of improvement alongside flare-ups triggered by factors such as poor sleep, stress or overexertion.
✔ Treatment can help
Education, pacing, exercise and personalised support can significantly improve symptoms and quality of life.
UNDERSTANDING THE CONDITION
Fibromyalgia (also known as fibromyalgia syndrome or FMS) is a long-term condition characterised by widespread pain lasting for at least three months, together with persistent fatigue, unrefreshing sleep and difficulties with memory, concentration or clear thinking.
It is one of the most common causes of chronic widespread pain and is classified by the National Institute for Health and Care Excellence (NICE) as a form of chronic primary pain—a condition in which the pain itself becomes the main health problem rather than simply being a symptom of another disease.
Fibromyalgia is now recognised worldwide as a genuine medical condition. Although it is diagnosed more frequently in women than men, it can affect people of any age or sex. The condition often develops gradually, although some people notice symptoms beginning after a physical injury, a significant illness, surgery or a period of prolonged physical or emotional stress.
One of the most important things to understand is that fibromyalgia does not damage the body. Unlike inflammatory arthritis, osteoarthritis or other musculoskeletal diseases, it does not destroy joints, weaken bones or progressively damage muscles. Despite this, the pain experienced is entirely real and can have a profound impact on everyday life.
Current research suggests that fibromyalgia results primarily from changes in the way the central nervous system processes pain. This process, known as central sensitisation, means that the brain and spinal cord become unusually sensitive to incoming sensory information. As a result, sensations that would normally be perceived as mild discomfort—or not painful at all—may be interpreted as significant pain.
You may hear this described as the nervous system's "pain volume control" being turned up too high. Instead of accurately filtering sensory information, the nervous system amplifies normal signals, making everyday activities such as walking, climbing stairs, carrying shopping, sitting for prolonged periods or even light touch feel uncomfortable or painful.
Importantly, this does not mean that the pain is imagined or "psychological". Modern neuroscience has demonstrated measurable changes in pain-processing pathways in people living with fibromyalgia. The pain arises from altered nervous system function rather than ongoing tissue injury.
Fibromyalgia is considered a chronic condition, meaning symptoms often fluctuate over many years.
However, chronic does not mean permanent deterioration. Most people experience periods when symptoms improve and others when they temporarily worsen. Understanding these patterns and learning how to manage them is one of the cornerstones of successful long-term management.
With appropriate education, pacing strategies, regular physical activity, good sleep management and personalised support, many people experience meaningful improvements in pain, energy levels, physical function and overall quality of life. Although there is currently no single cure, effective management can often help people regain confidence, independence and participation in everyday activities.
COMMON SYMPTOMS
Fibromyalgia affects people in different ways, and no two individuals experience exactly the same pattern of symptoms. While widespread pain is the defining feature, many people find that fatigue, poor sleep or difficulties with concentration have an even greater impact on their daily lives. Symptoms often fluctuate over time, with periods of relative stability alternating with flare-ups.
Pain
Pain is typically widespread, affecting both sides of the body and occurring above and below the waist. It may be described as:
A constant aching or burning sensation
Deep muscular pain
Sharp or stabbing pains
Tenderness when touched
Pain that moves from one area of the body to another
Many people also notice increased sensitivity to pressure, temperature or light touch.
Fatigue
Persistent fatigue is one of the most common symptoms of fibromyalgia. This is not simply feeling tired after a busy day, but a profound lack of physical and mental energy that may persist even after adequate rest.
People often describe:
Waking feeling exhausted
Reduced physical stamina
Feeling "drained" after relatively small activities
Difficulty recovering after exertion
Sleep Disturbance
Although many people sleep for an adequate number of hours, sleep is frequently unrefreshing. Poor-quality sleep can increase pain sensitivity, creating a cycle in which pain disrupts sleep and poor sleep worsens pain.
Common problems include:
Difficulty falling asleep
Frequent waking during the night
Light, non-restorative sleep
Feeling unrefreshed on waking
Cognitive Difficulties ("Fibro Fog")
Many people experience problems with thinking and concentration, often referred to as fibro fog. These symptoms can be as disabling as the pain itself.
They may include:
Difficulty concentrating
Forgetfulness
Slower thinking
Problems finding the right words
Difficulty planning or multitasking
These symptoms often become more noticeable during periods of fatigue, stress or poor sleep.
Other Symptoms
Fibromyalgia may also be associated with:
Morning stiffness
Headaches or migraine
Irritable bowel syndrome (IBS)
Bloating or digestive discomfort
Increased sensitivity to light, sound or temperature
Numbness or tingling sensations
Restless legs
Dizziness
Anxiety or low mood
Not everyone experiences all of these symptoms, and their severity varies considerably from person to person.
Flare-Ups
Many people experience temporary periods during which symptoms become noticeably worse. These are commonly referred to as flare-ups.
Triggers differ between individuals but may include:
Physical overexertion
Emotional stress
Poor sleep
Viral infections
Changes in routine
Cold or damp weather
Learning to recognise personal triggers is often an important step towards reducing the frequency and severity of flare-ups.
CAUSES, MECHANISMS AND DIAGNOSIS
Why Does It Happen?
Despite decades of research, no single cause has been identified for fibromyalgia. Instead, current evidence suggests that it develops through a combination of biological, genetic and environmental factors that alter how the nervous system processes pain.
The best-supported explanation is central sensitisation.
Normally, the brain and spinal cord continuously filter information coming from the body, deciding which signals deserve attention and which can safely be ignored. In fibromyalgia, this filtering system becomes overly sensitive. As a result, ordinary sensations may be amplified and interpreted as painful.
Research has demonstrated measurable changes in several areas involved in pain processing, including altered communication between the brain and spinal cord, changes in pain-modulating neurotransmitters and reduced efficiency of the body's natural pain-inhibiting systems. These findings reinforce that fibromyalgia is a genuine neurological pain disorder rather than a condition caused by tissue injury.
Although the exact reason why central sensitisation develops remains uncertain, several factors appear to increase the likelihood of developing fibromyalgia.
These include:
A family history of fibromyalgia or chronic pain conditions
Physical trauma or injury
Major surgery
Certain viral or bacterial infections
Persistent psychological or emotional stress
Long-standing painful medical conditions
Prolonged sleep disturbance
For many people, there is no single trigger. Instead, symptoms appear to develop gradually over time as several contributing factors interact.
It is equally important to understand what fibromyalgia is not.
Current evidence does not support fibromyalgia being caused by:
Ongoing inflammation
Joint damage
Muscle degeneration
Autoimmune disease
Progressive structural damage
This explains why X-rays, MRI scans and routine blood tests are usually normal despite significant pain and fatigue.
Rather than reflecting damage within the body, the symptoms arise because the nervous system has become more sensitive to normal sensory input.
Understanding this distinction is often reassuring. While the symptoms can be severe, they are not a sign that the body is progressively wearing out. This understanding also forms the basis of many of the treatments used to help reduce symptoms and improve daily function.
How It Is Diagnosed
There is currently no single blood test, scan or biopsy that confirms fibromyalgia.
Instead, diagnosis is based on a careful clinical assessment that considers your symptoms, medical history and examination findings while excluding other conditions that could produce similar symptoms.
Most clinicians use internationally recognised criteria developed by the American College of Rheumatology (ACR). These consider:
Widespread pain affecting multiple areas of the body
Symptoms lasting at least three months
The presence and severity of fatigue, sleep disturbance and cognitive symptoms
The absence of another condition that better explains the symptoms
Although no laboratory test confirms fibromyalgia, your GP or specialist will often arrange blood tests to exclude other medical conditions that can present in a similar way.
These may include tests for:
Thyroid disorders
Inflammatory arthritis
Vitamin deficiencies
Iron deficiency
Autoimmune diseases
Other metabolic or hormonal conditions
These investigations are performed to rule out alternative diagnoses, not because fibromyalgia itself produces abnormal blood results.
Receiving a diagnosis can be an important step. Many people have lived with unexplained symptoms for years before finally understanding what is happening. A clear diagnosis allows appropriate management to begin and often prevents unnecessary investigations or referrals.
Diagnosis should never be based solely on pain. Good clinical assessment also considers how symptoms affect sleep, physical function, emotional wellbeing, work, family life and overall quality of life.
HOW IS IT USUALLY MANAGED?
Management depends on the diagnosis, symptom severity, underlying mechanisms and each person's individual circumstances.
There is currently no cure for fibromyalgia, but many people achieve meaningful improvements in symptoms through a combination of education, lifestyle changes, physical rehabilitation and, where appropriate, medication.
Current UK guidance recommends an individualised, multidisciplinary approach rather than relying on any single treatment.
Education
Education is one of the most important aspects of treatment.
Understanding how fibromyalgia affects the nervous system helps many people feel more confident about managing their symptoms. Knowing that pain does not reflect ongoing damage often reduces fear, allowing a gradual return to normal activities.
Physical Activity
Regular physical activity is among the most consistently supported treatments for fibromyalgia.
Research shows that appropriately paced exercise can improve:
Pain
Fatigue
Physical function
Mood
Overall quality of life
Activities may include:
Walking
Swimming
Cycling
Gentle strengthening exercises
Stretching programmes
The key is gradual progression. Increasing activity too quickly can trigger a flare-up, whereas slow and consistent progress is generally associated with better long-term outcomes.
Medication
Medication may help some people but is rarely sufficient on its own.
Depending on your individual circumstances, your GP or specialist may recommend medicines such as:
Amitriptyline
Duloxetine
Pregabalin
These medicines aim to reduce pain sensitivity and improve sleep rather than treat inflammation.
By contrast, standard painkillers such as paracetamol or anti-inflammatory medicines (NSAIDs) are generally much less effective because fibromyalgia pain is not caused by tissue inflammation.
Medication decisions should always be discussed with your prescribing clinician, taking into account the potential benefits and side effects.
Psychological Support
Living with persistent pain can affect mood, confidence and coping.
Approaches such as cognitive behavioural therapy (CBT) may help some people develop practical strategies for managing symptoms, improving sleep and maintaining everyday activities. These therapies are not intended to suggest that fibromyalgia is a psychological condition, but rather recognise the close relationship between chronic pain, stress, sleep and emotional wellbeing.
Specialist Care
Most people can be managed successfully in primary care. However, referral to a rheumatologist or specialist pain service may be appropriate when:
The diagnosis remains uncertain
Symptoms are particularly severe
Another underlying condition is suspected
A multidisciplinary pain management programme may be beneficial
Successful management is usually achieved through a combination of education, self-management, regular physical activity and ongoing support tailored to the individual's needs.
LIVING WELL WITH THE CONDITION
Impact on Daily Life
Living with fibromyalgia can be challenging, particularly because symptoms often fluctuate from day to day. Many people experience periods where they feel relatively well, followed by flare-ups during which pain, fatigue or cognitive difficulties become more pronounced. Learning how to recognise these patterns is an important part of successful long-term management.
Pacing Your Activities
One of the most valuable self-management strategies is pacing. Rather than alternating between doing too much on good days and needing prolonged rest afterwards—the so-called "boom and bust" cycle—pacing encourages a more balanced and sustainable approach to daily activities.
This may involve:
Breaking larger tasks into smaller steps
Taking regular planned breaks
Gradually increasing activity levels
Prioritising the activities that matter most to you
Although progress may sometimes feel slow, consistency generally produces better long-term results than repeatedly pushing through pain.
Looking After Your Sleep
Sleep and pain are closely connected. Poor-quality sleep can increase pain sensitivity, while pain itself can make restful sleep more difficult.
Simple measures that may help include:
Maintaining regular bedtimes and waking times
Creating a calm bedtime routine
Reducing screen use before bed
Limiting caffeine late in the day
Addressing factors such as pain or anxiety that may interfere with sleep
Improving sleep quality often leads to improvements in fatigue, concentration and pain.
Staying Physically Active
Although movement may initially seem difficult, avoiding activity altogether can gradually reduce strength, fitness and confidence.
Most experts recommend remaining as active as possible within your own limits. Gentle, regular exercise usually provides greater long-term benefits than periods of intense activity followed by prolonged rest.
The goal is not to exercise through severe pain, but to find a sustainable level of activity that can gradually be increased over time.
Work, Family and Daily Life
Fibromyalgia often affects more than physical health alone. Fatigue, pain and cognitive symptoms can influence work, family responsibilities, relationships and social activities.
Many people benefit from simple adjustments such as:
Flexible working arrangements
Planned rest periods
Prioritising important activities
Explaining the condition to family members or employers
Helping those around you understand that fibromyalgia is a recognised medical condition can reduce misunderstandings and provide valuable support.
Managing Flare-Ups
Flare-ups are a normal part of living with fibromyalgia and do not necessarily indicate that the condition is worsening.
Having a personalised flare-up plan may help you recover more quickly. This might include temporarily reducing activity levels, maintaining gentle movement where possible, prioritising sleep and gradually returning to your usual routine as symptoms improve.
Rather than viewing flare-ups as setbacks, many people learn to recognise them as periods that require temporary adjustment before returning to their normal level of activity.
HOW ROWAN HEALTH SUPPORTS YOU
Every person experiences fibromyalgia differently. Although the diagnosis may be the same, the balance between pain, fatigue, sleep disturbance, cognitive symptoms and the impact on daily life varies considerably from one individual to another.
At Rowan Health, we begin with a comprehensive assessment designed to understand not only your diagnosis, but also how the condition affects your overall health, lifestyle and quality of life. Together, we explore the factors most likely to influence your symptoms, including your pattern of pain and fatigue, sleep quality, physical activity, emotional wellbeing, existing medical conditions, current treatments and your personal goals.
Rather than offering standardised treatment packages, we use this information to develop a personalised supportive care protocol tailored to your individual needs and priorities. Depending on your assessment, your protocol may combine education, lifestyle guidance, symptom monitoring and carefully selected supportive interventions, chosen according to your clinical presentation and treatment goals. Where clinically appropriate, these may include medical acupuncture, manual therapies, herbal medicine, medical homeopathy and neuro-coaching, integrated within a coordinated care programme rather than delivered as isolated treatments.
Education remains central to our approach. Understanding why symptoms occur and learning practical strategies to manage them can help you feel more confident managing flare-ups, pacing activities and making informed decisions about your health. As your symptoms, progress and priorities change over time, your care protocol is reviewed and adapted accordingly.
Where appropriate, we also communicate with your GP or specialist to help ensure your care remains coordinated within your wider healthcare pathway.
Our aim is not simply to reduce individual symptoms, but to improve function, build resilience, restore confidence and support your long-term quality of life.
When to Seek Medical Advice
Although fibromyalgia itself is not a life-threatening condition, new or unusual symptoms should never automatically be assumed to be part of fibromyalgia.
You should seek prompt medical assessment if you develop:
Unexplained weight loss
Persistent fever or drenching night sweats
New swollen, red or hot joints
Progressive muscle weakness
New numbness or loss of sensation
Loss of bladder or bowel control
Severe or persistent chest pain
Unexplained shortness of breath
A new, severe or unusual headache
Rapidly worsening neurological symptoms
These symptoms are not typical features of fibromyalgia and may indicate another medical condition requiring urgent assessment.
If you experience severe symptoms such as chest pain, difficulty breathing, sudden weakness, or signs of stroke, call 999 immediately or attend your nearest Emergency Department.
If your symptoms are severe, rapidly worsening or causing immediate concern, contact NHS 24 on 111. In a medical emergency, call 999 or attend your nearest Accident & Emergency department.
FAQs
Is fibromyalgia a recognised medical condition?
Yes. Fibromyalgia is recognised by major medical organisations worldwide, including the NHS, NICE, the American College of Rheumatology and the European Alliance of Associations for Rheumatology (EULAR). Research has demonstrated measurable changes in the way the nervous system processes pain.
Does fibromyalgia damage the body?
No. Although symptoms can be severe, fibromyalgia does not damage the joints, muscles or internal organs and does not cause permanent tissue destruction.
Can fibromyalgia be cured?
There is currently no single cure. However, many people experience substantial improvements in pain, fatigue and quality of life through education, regular physical activity, pacing, sleep management and personalised supportive care.
Is fibromyalgia the same as chronic fatigue syndrome (ME/CFS)?
No. While the two conditions share some symptoms, they are distinct disorders.
Fibromyalgia is primarily characterised by widespread pain and tenderness, whereas ME/CFS is defined mainly by profound fatigue and post-exertional malaise. Some people meet the diagnostic criteria for both conditions.
Should I continue exercising if exercise increases my pain?
In most cases, yes—but the approach is important. Research consistently supports gradual, individually paced exercise rather than complete rest or intensive training. Building activity slowly usually produces better long-term outcomes.
Is fibromyalgia a form of arthritis?
No. Unlike arthritis, fibromyalgia does not cause inflammation or damage within the joints. The pain results from altered pain processing within the nervous system rather than structural joint disease.
Can weather affect fibromyalgia?
Many people report that cold, damp weather or sudden changes in atmospheric pressure make their symptoms worse. Although scientific studies have produced mixed results, recognising your own symptom patterns may help you plan activities and manage flare-ups more effectively.
Sources & references
National Institute for Health and Care Excellence (NICE). Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain (NG193). 2021.
NHS. Fibromyalgia.
Wolfe F, Clauw DJ, Fitzcharles MA, et al. 2016 Revisions to the 2010/2011 Fibromyalgia Diagnostic Criteria. Seminars in Arthritis and Rheumatism. 2016.
Berwick R, Barker C, Goebel A. The diagnosis of fibromyalgia syndrome. Clinical Medicine. 2022.
Bidonde J, et al. Aerobic exercise training for adults with fibromyalgia. Cochrane Database of Systematic Reviews. 2017.
Bidonde J, et al. Mixed exercise training for adults with fibromyalgia. Cochrane Database of Systematic Reviews. 2019.
Häuser W, Fitzcharles MA. Fibromyalgia: advances in diagnosis and management. BMJ. 2023.
Clinical Review
Clinical content reviewed by
Rowan Health
Last reviewed:
21 July 2026
Related Resources
You may also find the following pages helpful to better understand fibromyalgia, its symptoms and the different approaches to managing the condition.
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Central Sensitisation
Treatment and Support
What Is Integrative Medicine? >
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Every person's experience of fibromyalgia is unique. Following a comprehensive assessment, we develop a personalised supportive care programme tailored to your individual needs, combining education with carefully selected integrative interventions where appropriate. Our aim is to help improve symptom control, daily function and quality of life.