Skip to Content
Fibromyalgia is a condition in which a person has long-term pain that is spread throughout the body. The pain is most often linked to fatigue, sleep problems, headaches, depression, and anxiety.
People with fibromyalgia may also have tenderness in the joints, muscles, tendons, and other soft tissues.
Fibromyositis; FM; Fibrositis
The cause is not known. Researchers think that fibromyalgia is due to a problem with how the central nervous system processes pain. Possible causes or triggers of fibromyalgia include:
Fibromyalgia is more common in females as compared to males. Women ages 20 to 50 are most affected.
The following conditions may be seen with fibromyalgia or have similar symptoms:
Pain is the main symptom of fibromyalgia.
The areas where pain occurs are called tender points. These points are found in the soft tissue on the back of the head, neck, shoulders, chest, lower back, hips, elbows, and knees. The pain then spreads out from these areas. The qualities of the pain are:
People with fibromyalgia tend to wake up with body pain and stiffness. For some people, pain improves during the day and gets worse at night. Some people have pain all day long.
Pain may get worse with:
Most of the people with fibromyalgia have fatigue, depressed mood, and sleep problems. Many people say that they cannot get to sleep or stay asleep, and they feel tired when they wake up.
Other symptoms of fibromyalgia may include:
To be diagnosed with fibromyalgia, you must have had at least 3 months of widespread pain with one or more of the following:
It is not necessary to find tender points during the exam to make a diagnosis.
Results from the physical exam, blood and urine tests, and imaging tests are normal. These tests may be done to rule out other conditions with similar symptoms. Studies of breathing during sleeping may be done to find out if you have a condition called sleep apnea.
Fibromyalgia may also occur in people who have other forms of arthritis, such as:
The goals of treatment are to help relieve pain and other symptoms, and to help the person cope with the symptoms.
The first type of treatment may involve:
If these treatments do not work, your health care provider may also prescribe an antidepressant or muscle relaxant. Sometimes, combinations of medicines are helpful.
Other medicines are also used to treat the condition, such as:
If you have sleep apnea, a device called continuous positive airway pressure (CPAP) may be prescribed.
Cognitive-behavioral therapy is an important part of treatment. This therapy helps you learn how to:
Complementary and alternative treatments may also be helpful. These may include:
Support groups may also help.
Things you can do to help take care of yourself include:
Your provider may refer you to a pain clinic if your condition is severe.
Fibromyalgia is a long-term disorder. Sometimes, the symptoms improve. Other times, the pain may get worse and continue for months or years.
Call your provider if you have symptoms of fibromyalgia.
There is no known prevention.
Bennett RM. Fibromyalgia, chronic fatigue syndrome, and myofascial pain. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 274.
Bernardy K, Klose P, Busch AJ, Choy EH, Hauser W. Cognitive behavioural therapies for fibromyalgia. Cochrane Database Syst Rev. 2013;(9):CD009796. PMID: 24018611 www.ncbi.nlm.nih.gov/pubmed/24018611.
Clauw DJ. Fibromyalgia: a clinical review. JAMA. 2014;311(15):1547-1555. PMID: 24737367 www.ncbi.nlm.nih.gov/pubmed/24737367.
Clauw DJ. Fibromyalgia and related syndromes. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2015:chap 80.
Crofford LJ. Fibromyalgia. In: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, eds. Kelley and Firestein's Textbook of Rheumatology. 10th ed. Philadelphia, PA: Elsevier; 2017:chap 52.
Gilron I, Chaparro LE, Tu D, et al. Combination of pregabalin with duloxetine for fibromyalgia: a randomized controlled trial. Pain. 2016; 157(7):1532-1540. PMID: 26982602 www.ncbi.nlm.nih.gov/pubmed/26982602.
Lauche R, Cramer H, Häuser W, Dobos G, Langhorst J. A systematic overview of reviews for complementary and alternative therapies in the treatment of the fibromyalgia syndrome. Evid-Based Complement Alternat Med. 2015; 2015:610615. www.hindawi.com/journals/ecam/2015/610615/.
Marvisi M, Balzarini L, Mancini C, Ramponi S, Marvisi C. Fibromyalgia is frequent in obstructive sleep apnea and responds to CPAP therapy. Eur J Intern Med. 2015;26(9):e49-e50. PMID: 26129987 www.ncbi.nlm.nih.gov/pubmed/26129987.
Wu YL, Chang LY, Lee HC, Fang SC, Tsai PS. Sleep disturbances in fibromyalgia: A meta-analysis of case-control studies. J Psychosom Res. 2017; 96:89-97. PMID: 28545798 www.ncbi.nlm.nih.gov/pubmed/28545798.
Reviewed By: Gordon A. Starkebaum, MD, ABIM Board Certified in Rheumatology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.