Fibromyalgia: A practical guide to treating pain, fatigue, and brain fog

Fibromyalgia is a chronic condition that causes pain in the muscles and joints throughout the body. While researchers don’t know what causes fibromyalgia, it’s a real health condition that affects at least four million adults in the United States. There is no test to diagnose it—and no cure—but your doctor can help you find treatments to manage your symptoms and improve your quality of life.

What is fibromyalgia?

People with fibromyalgia experience widespread pain accompanied by fatigue, memory loss, emotional distress, and other symptoms. Researchers believe that the condition heightens sensations by changing the way the brain and spinal cord process pain signals. Chemicals that play a role in signaling pain may rise to abnormal levels.

As researchers study potential causes of fibromyalgia, they are examining genetic mutations in neurotransmitters in the brain that send and receive pain signals to and from the body.

Muscle pain is often the first sign of fibromyalgia. Symptoms may gradually develop over time or be triggered by an event, such as stress, trauma, surgery, or an infection. While women are more likely to develop fibromyalgia than are men, the condition can affect people of any gender.

Symptoms of fibromyalgia

The widespread pain associated with fibromyalgia is a constant, dull ache that occurs on both sides of the body—above and below the waist—and lasts for at least three months. Fibromyalgia pain may feel like burning, aching, stabbing, tingling, throbbing, soreness, or numbness. If you have the condition, you may experience different types of pain at different times of day.

The most common symptoms of fibromyalgia include:

  • Pain and stiffness all over the body
  • Fatigue and tiredness
  • Sensitivity to touch
  • Memory loss
  • Difficulty concentrating
  • Sleep problems
  • Tension headaches and migraines
  • Depression and anxiety

A symptom referred to as “fibro fog” makes it difficult to focus and pay attention. People with fibromyalgia may be forgetful or have poor judgement, and they may have trouble learning and understanding. If you have the condition, you may experience low energy, even after sleeping for a long period of time.

Fibromyalgia is also associated with other sleep disorders, including restless legs syndrome and sleep apnea. Other symptoms include diarrhea and constipation, bladder control issues, and temporomandibular joint (TMJ) disorders.

Risk factors for fibromyalgia

People with chronic illnesses—including osteoarthritis, rheumatoid arthritis, anxiety and depression, chronic back pain, irritable bowel syndrome, or lupus—are more likely to develop fibromyalgia. Studies have found that major changes in life may also trigger the condition. Other risk factors for fibromyalgia include:

Age. The condition is more common in people older than 40.

Sex assigned at birth. Those assigned female at birth are twice as likely to develop fibromyalgia.

Family history. Your risk for developing fibromyalgia rises if a biological parent or sibling has the condition.

Stress. Long-term stress may be a trigger.

Infections. Having an infection with severe symptoms may lead to fibromyalgia.

Trauma. A serious injury or emotional event can sometimes cause the condition.

How to improve your quality of life when you have fibromyalgia

Treating fibromyalgia may involve a healthcare team that includes a primary care doctor, rheumatologist, physical therapist, occupational therapist, and behavioral health professional. Every person with fibromyalgia is different, and the condition affects people in unique ways.

Effective treatments for fibromyalgia allow some people to experience fewer flare-ups with milder symptoms that interfere less with the activities of daily life. While there is no cure for fibromyalgia, working with your healthcare team to develop a personal treatment plan can help control your symptoms.

Engage in physical activity. Exercising a few days a week can help reduce pain, increase energy, boost mood, and improve sleep. Adults should get 150 minutes of moderate physical activity—like walking, swimming, or biking—each week. That’s 30 minutes a day, five days a week. If it’s easier for you, try breaking activity down into three separate ten-minute sessions during the day. If you haven’t exercised recently, ask your doctor to recommend activities that are right for you.

Your healthcare provider may recommend that you work with a physical therapist who can teach you how to stretch and strengthen your muscles and joints. For some, strength training may relieve the symptoms of fibromyalgia. If you find it difficult to participate in regular activities, an occupational therapist can help you navigate your daily routine.

Take your medication as prescribed. Your healthcare provider may prescribe medicine to relieve pain or recommend that you take an over-the-counter pain reliever. Always check with your doctor or pharmacist before you adjust or stop taking a medication.

See a therapist. People with fibromyalgia are at least three times more likely to have major depression than those without the condition. That’s why it’s so important to be screened for depression and to start cognitive behavioral therapy (CBT) to treat underlying depression. CBT is a type of therapy that can help change the way you act and think.

Take steps to reduce stress. Relaxation techniques such as meditation, deep breathing, visualization, yoga, tai chi, and massage can help you cope with anxiety, stress, and depression.

Practice self-care. Eat a healthy diet rich in fruits and vegetables, make time to relax each day, and go to bed at the same time each night. If you suffer from fibromyalgia, making healthy lifestyle choices can improve your chances of having a good quality of life.

While its precise cause remains unknown—and while you may find it hard to describe your symptoms—fibromyalgia is a real condition that affects millions of Americans. Until researchers find a cure, your healthcare provider can recommend treatments that can help relieve your symptoms, manage stress, maintain a healthy self-image, and get back to being you.