Fibromyalgia
Fibromyalgia syndrome, chronic widespread pain
Chronic conditionWidespread pain that lasts 3 months or more, with fatigue, poor sleep, and brain fog. It's real and common, and it comes from changes in how the nervous system handles pain.
Medical Disclaimer
For education only — this guide can't diagnose you. If these signs sound familiar, talk with a healthcare provider. Book a consult
What happens
In fibromyalgia, the brain and spinal cord turn up pain signals, so pain feels stronger than expected and normal touch can hurt. This is called central sensitization. Blood tests and scans are normal, and the joints and muscles aren't damaged. It's diagnosed from the pattern of symptoms after other causes are ruled out. Fibromyalgia often occurs alongside autoimmune diseases such as lupus, rheumatoid arthritis, Sjögren's, and Hashimoto's. Those need to be checked for, because they're treated differently and can be missed when pain is blamed on fibromyalgia. Poor sleep, stress, trauma, and infections can trigger or worsen it.
Who gets it
Fibromyalgia affects about 2 to 4 percent of adults and is diagnosed more often in women, often between ages 30 and 60. It's much more common in women with lupus, rheumatoid arthritis, Sjögren's, and other autoimmune diseases. A family history, past trauma, and long-term sleep problems also raise the risk.
Signs worth getting checked
- Aching pain on both sides of the body, above and below the waist
- Fatigue that rest doesn't fix
- Unrefreshing sleep
- Brain fog and trouble with memory or focus ('fibro fog')
- Tenderness and sensitivity to touch, cold, light, or noise
- Headaches or migraines
- Bloating, cramping, or bowel changes like IBS
- Numbness or tingling in the hands and feet
- Low mood or anxiety
Labs to ask about
- CBC, metabolic panel, ESR, and CRP
- TSH
- CK if you have muscle weakness
- ANA, rheumatoid factor, and anti-CCP if you have joint swelling, rashes, dry eyes and mouth, or other signs of autoimmune disease
- Vitamin D, ferritin, and B12
- A sleep study if you snore or wake unrefreshed
Treatments your doctor may discuss
- Regular exercise, started gently and built up slowly, which has the strongest evidence
- Education about the condition, and CBT or other pain-focused therapy
- Medicines such as duloxetine, milnacipran, pregabalin, or low-dose amitriptyline
- Treating sleep problems, mood symptoms, and any autoimmune disease you also have
- Opioids aren't recommended. They work poorly for fibromyalgia and carry real risks.
Supportive steps to discuss with your provider
- Start with gentle movement, such as walking or water exercise, and add a little at a time.
- Ask whether tai chi, yoga, or acupuncture could help. Each has some evidence for fibromyalgia.
- Keep regular sleep and wake times, and limit caffeine later in the day.
- Pace yourself on good days so you don't crash afterward.
- Tell your provider about new symptoms such as joint swelling, rashes, fevers, or dry eyes and mouth, so autoimmune disease can be rechecked.
See a doctor promptly if you have
- New back pain with leg weakness, numbness in the groin, or loss of bladder control: go to the emergency room
- Thoughts of suicide: call or text 988, or call 911 if you're in immediate danger
- Joint swelling, a rash, fever, or mouth sores
- Muscle weakness rather than just pain, or dark urine
- Unexplained weight loss or night sweats
Related conditions
Ready to find the root cause?
Dr. Lesher is a Naturopathic Doctor who focuses on autoimmune and chronic conditions in women. Since 2020, she's helped hundreds of patients stop managing symptoms and start healing.