What is fibromyalgia?
Fibromyalgia is a long-term condition that can cause widespread pain, deep fatigue, poor sleep, and a range of other symptoms that can be difficult to explain.
A common explanation is that the body’s pain system becomes more sensitive than usual. This is sometimes called central sensitisation. It means the brain and spinal cord may amplify pain signals, so sensations that would not usually be painful may feel painful, or pain may feel more intense than expected.
For many people, one of the hardest parts is feeling unwell while tests appear normal. This can be frustrating, especially if you have spent a long time trying to understand what is going on.
Fibromyalgia is real. It is not caused by laziness, weakness, or “just stress”. It is also not simply “all in your head”. Stress can worsen symptoms, but it does not mean the condition is imagined.
This guide explains what fibromyalgia can feel like, what may contribute to it, how it is diagnosed, and what support may be available.
This page is for general education only and is not medical advice. If you are concerned about your health, please speak with your GP or another qualified healthcare professional.
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Fibromyalgia symptoms
The main symptom of fibromyalgia is widespread pain, but it is rarely just pain. Many people experience a combination of symptoms that can change from day to day.
Common symptoms may include:
- Widespread pain, often felt as aching, burning, throbbing, or tenderness across different areas of the body
- Fatigue that does not always improve with rest
- Unrefreshing sleep, including waking up tired even after a full night’s sleep
- Difficulty with memory, focus, or word-finding, sometimes called “fibro fog”
- Morning stiffness or stiffness after sitting or resting
- Increased sensitivity to pain, touch, light, noise, temperature, or smell
- Headaches or migraines
- Digestive symptoms, which may overlap with irritable bowel syndrome, or IBS
- Low mood, anxiety, or feeling emotionally worn down
Symptoms often begin within a few months of a traumatic event, but they can also appear later. They may come and go, and they can be triggered by reminders such as sounds, smells, places, anniversaries, conversations, or situations that feel connected to what happened.
Is fibromyalgia autoimmune or neurological?
Fibromyalgia is not considered an autoimmune disease. Unlike conditions such as lupus or rheumatoid arthritis, fibromyalgia does not involve the immune system attacking the body in a way that causes joint or organ damage.
It is better understood as a chronic pain condition involving changes in pain processing and nervous system sensitivity. Some people may also have fibromyalgia alongside autoimmune or inflammatory conditions, which can make diagnosis and management more complex.
This distinction matters because different conditions need different types of treatment and monitoring.
What causes fibromyalgia?
There is no single known cause of fibromyalgia. Current understanding suggests it develops from a mix of factors that affect how the nervous system processes pain.
Possible contributing factors include:
- Genetics and family history
- Physical trauma, injury, surgery, or infection
- Significant emotional stress or long-term stress
- Poor or disrupted sleep
Other health conditions, including chronic pain conditions, IBS, migraine, rheumatoid arthritis, or lupus
For some people, symptoms begin after a clear trigger. For others, symptoms build slowly over time with no obvious starting point.
How is fibromyalgia diagnosed?
There is no single blood test, scan, or online questionnaire that can diagnose fibromyalgia.
Fibromyalgia is diagnosed through a clinical assessment. This means your doctor or specialist will look at your symptoms, medical history, how long symptoms have been present, and how they affect your daily life.
Current diagnostic approaches usually consider:
- Widespread pain across several areas of the body
- Symptoms that have been present for at least three months
- Fatigue, unrefreshing sleep, and cognitive symptoms such as memory or concentration difficulties
- The overall severity and impact of symptoms
- Whether another condition may be contributing to, or better explaining, your symptoms
Older approaches focused on pressing specific “tender points” around the body. These are no longer required for diagnosis.
Your doctor may request blood tests or other investigations. These tests do not confirm fibromyalgia, but they can help check for other possible causes of pain, fatigue, stiffness, or inflammation, such as thyroid problems, inflammatory arthritis, autoimmune disease, anaemia, or vitamin deficiencies.
Fibromyalgia can also exist alongside other conditions. A diagnosis does not always mean every other health condition has been ruled out. It means your overall symptom pattern is consistent with fibromyalgia and has been assessed by a health professional.
Getting a diagnosis can take time, especially when symptoms overlap with other conditions. This can be frustrating, but a clear diagnosis can help guide the right support and management plan.
Fibromyalgia and chronic fatigue syndrome
Fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome, often called ME/CFS, can overlap. Some people may be diagnosed with both. The main difference is usually the dominant symptom pattern. Fibromyalgia is most strongly associated with widespread pain and increased sensitivity to pain.
ME/CFS is most strongly associated with profound fatigue and post-exertional malaise. Post-exertional malaise means symptoms become significantly worse after physical, mental, or emotional effort, even when the activity seems minor.
Both conditions can involve poor sleep, brain fog, pain, and reduced ability to manage day-to-day activities. Because they can look similar and sometimes occur together, it is important to speak with a health professional for proper assessment.
Fibromyalgia and lupus
Fibromyalgia and lupus can share symptoms such as fatigue, widespread pain, brain fog, and low mood. They can also occur together.
The key difference is that lupus is an autoimmune disease. It can cause inflammation and may affect organs such as the skin, joints, kidneys, heart, lungs, or brain. Lupus can often be monitored through blood tests, urine tests, symptoms, and clinical examination.
Fibromyalgia does not cause the same type of immune attack, inflammation, or organ damage. It also does not usually show up in routine blood tests.
Because the treatments are different, it is important to get the right diagnosis. If symptoms are changing, worsening, or unusual for you, it is worth speaking with your doctor.
Fibromyalgia and multiple sclerosis
Fibromyalgia and multiple sclerosis, or MS, can both involve fatigue, pain, and cognitive symptoms. However, they are different conditions.
MS is a neurological condition where the immune system damages the protective covering around nerves. It can cause symptoms such as numbness, weakness, vision changes, balance problems, and changes that may be visible on MRI scans.
Fibromyalgia does not damage the nerves in the same way and does not usually show up on scans. It is more commonly associated with widespread pain, sensitivity, fatigue, poor sleep, and cognitive symptoms.
If symptoms include numbness, weakness, changes in vision, loss of balance, or other neurological changes, medical assessment is important.
Treatment and management options
There is currently no cure for fibromyalgia, but symptoms can often be managed with the right combination of support.
Treatment is usually tailored to the person. What works well for one person may not work for another, so it can take time to find the right approach.
Management may include movement, pacing, sleep support, psychological support, medication, stress management, and support for any other health conditions.
Movement and exercise
Gentle, regular movement is one of the most commonly recommended management strategies for fibromyalgia.
This might include walking, swimming, cycling, water-based exercise, stretching, tai chi, yoga, or supervised strengthening work.
The key is to start low and build slowly. Doing too much too soon can trigger a flare-up. A physiotherapist or exercise professional with experience in chronic pain may be able to help you find a safe starting point.
Pacing
Pacing means balancing activity and rest so you do not repeatedly push past your limits and then crash.
This can involve breaking tasks into smaller steps, resting before symptoms become severe, planning recovery time, and avoiding the cycle of doing too much on a good day followed by several difficult days.
Pacing is not about doing nothing. It is about finding a more sustainable rhythm.
Psychological and behavioural support
Living with long-term pain and fatigue can affect mood, sleep, stress, relationships, and daily confidence.
Support such as cognitive behavioural therapy, mindfulness-based approaches, relaxation strategies, or pain management programmes may help some people manage the emotional and practical impact of fibromyalgia.
This does not mean the pain is psychological. It means the brain, body, stress system, sleep, and pain system are connected, and support in these areas can make symptoms easier to manage.
Medication
Some medicines may help reduce symptoms for some people.
These may include certain antidepressant medicines used at low doses for pain, or medicines used for nerve-related pain. Examples can include amitriptyline, duloxetine, pregabalin, or gabapentin, depending on the person and local prescribing guidance.
Medication is not suitable for everyone and should always be discussed with your doctor. The right choice depends on your symptoms, medical history, other medicines, side effects, and treatment goals.
Standard painkillers may not work well for fibromyalgia, and opioids are generally not recommended for long-term management.
Sleep support
Poor sleep can worsen pain, fatigue, mood, and concentration. Improving sleep is often an important part of fibromyalgia management.
Helpful steps may include keeping a regular sleep routine, reducing caffeine later in the day, limiting screen time before bed, creating a wind-down routine, and speaking with your doctor if pain, anxiety, breathing issues, or other symptoms are disrupting sleep.
Other support options
Other supports may also help, depending on the person. These can include:
- Physiotherapy
- Occupational therapy
- Pain management programmes
- Massage or gentle bodywork
- Acupuncture
- Relaxation techniques
- Support groups
- Symptom tracking
- Workplace or study adjustments
It is often helpful to take a broad approach rather than relying on one single treatment.
Published on 24.07.2026
Frequently Asked Questions
How do you explain fibromyalgia to someone?
One simple way to explain fibromyalgia is that the body’s pain system has become more sensitive than usual.
The brain and nervous system may register pain more strongly, or more often, even when there is no new injury or tissue damage. This can happen alongside fatigue, poor sleep, brain fog, and sensitivity to things like touch, sound, light, or temperature.
Fibromyalgia is an invisible condition, which can make it hard for others to understand. But invisible does not mean imaginary.
Does fibromyalgia come and go?
Fibromyalgia is usually a long-term condition, but symptoms can change over time.
Many people experience flare-ups and quieter periods. During a flare-up, pain, fatigue, sleep problems, and brain fog may feel more intense. During quieter periods, symptoms may be more manageable, although they may not disappear completely.
Understanding your triggers, pacing your activity, protecting sleep, and having a management plan can help reduce the impact of flare-ups.
Can fibromyalgia cause high blood pressure?
Fibromyalgia is not usually considered a direct cause of high blood pressure.
However, ongoing pain, poor sleep, stress, reduced activity, and some medicines can affect overall health.
If you are concerned about your blood pressure, or if you have headaches, dizziness, chest pain, or shortness of breath, speak with your doctor.
Is fibromyalgia a disability?
Fibromyalgia affects people differently.
For some people, symptoms are mild to moderate and can be managed with the right support. For others, pain, fatigue, brain fog, and flare-ups can have a significant impact on work, study, family life, and daily activities.
Whether it is considered a disability depends on how much it affects the person’s life and the context, such as work, study, or support needs.
Can fibromyalgia be mistaken for other conditions?
Yes. Fibromyalgia can share symptoms with other conditions, including thyroid problems, rheumatoid arthritis, lupus, multiple sclerosis, anaemia, vitamin deficiencies, chronic fatigue syndrome, depression, anxiety, and sleep disorders.
This is why a proper medical assessment is important.
What does a fibromyalgia flare feel like?
A flare-up can feel different for each person. Some people notice increased pain, heavier fatigue, worse sleep, more brain fog, mood changes, digestive symptoms, or increased sensitivity to touch, light, noise, or temperature.
Flares may last for a few days or longer. Tracking possible triggers can help you understand your own pattern.
Can lifestyle changes help fibromyalgia?
Lifestyle changes can help some people manage symptoms, but they are not a cure and they should not be framed as a simple fix.
Helpful strategies may include gentle movement, pacing, sleep routines, stress management, regular meals, reducing overexertion, and getting support for mood, anxiety, or other health conditions.
Is fibromyalgia curable?
Fibromyalgia is not usually described as curable. However, it can often be managed.
For some people, symptoms improve significantly with the right combination of treatment, lifestyle changes, pacing, and support. For others, symptoms continue but become easier to understand and manage over time.
Fibromyalgia is not considered a progressive condition in the same way as some inflammatory or neurological diseases. It does not cause the joint or organ damage seen in some autoimmune conditions.