What is fibromyalgia – Symptoms, causes and treatment of chronic fibromyalgia pain

Fibromyalgia is a chronic pain condition affecting approximately 2% of adults in the US. It causes widespread pain (pain all over the body), fatigue, sleep issues, as well as emotional and mental distress. While the cause of fibromyalgia is not known, there is effective treatment to manage symptoms and alleviate distress.

Fibromyalgi - Solnedgång över skog

What is fibromyalgia?

FIbromyalgia is a chronic pain condition characterized by musculoskeletal pain and/or an aching sensation which appears in different parts of the body and can be constant or come and go over time.

Fibromyalgia pain is often accompanied by fatigue, as well as gastrointestinal-, sleep-, mood-, cognitive-, and memory issues. It is also believed that most fibromyalgia sufferers have “central pain processing abnormalities”, such as abnormal pain perception processing, which may make them more sensitive to pain than others.

What are the symptoms of fibromyalgia?

The primary symptoms of fibromyalgia are:

Widespread chronic pain

Widespread pain is the main symptom of fibromyalgia. To be considered widespread, the pain should occur on both sides of the body, both above and below the waist. Chronic pain is pain that has lasted for at least three months.

Fibromyalgia pain is often described as a constant dull ache, but it can also come in the form of stiffness and joint pain. Some parts of the body may be more painful than others. Usually sufferers experience neck, shoulder and lower back pain.

Increased sensitivity to pain

It is believed that fibromyalgia amplifies painful sensations by affecting how the brain and spinal cord process painful and non-painful signals. The medical term for this is Hyperalgesia, literally “excess pain”, and this abnormal pain perception is a key difference between fibromyalgia and other illnesses or conditions with muscle pain.

Fatigue and tiredness

Another symptom of fibromyalgia is fatigue. People with fibromyalgia often experience disrupted sleep due to both fibromyalgia pain, and other connected sleep disorders such as restless legs syndrome and sleep apnea. As a result, fibromyalgia patients often wake up feeling tired, even though they are getting enough sleep.

Depression and anxiety

Depression and anxiety are closely linked to fibromyalgia. People with fibromyalgia are up to three times more likely to have depression at the time of their diagnosis than people without fibromyalgia. But it is not definitively known if it is the stress from the pain and fatigue of fibromyalgia that eventually lead to depression, or if anxiety and depression are as much a part of fibromyalgia as the physical pain.

Sleep problems

Sleep problems and fibromyalgia are so closely linked, that at one time, fibromyalgia was actually considered a sleep disorder. Sleep problems are also a key part of the spiral of worsening symptoms that fibromyalgia patients may experience since pain makes it difficult to fall asleep and stay asleep, and a lack of sleep lowers one’s pain threshold and magnifies pain perception. Insomnia can also cause or worsen anxiety and depression.

Cognitive issues

Cognitive issues, or brain fog associated with fibromyalgia are often called “fibro fog”. Fibro fog includes memory issues such as forgetfulness or trouble retaining new information, a loss of quick thinking, concentration issues, difficulty staying alert etc. Loss of mental clarity is twice as common in fibromyalgia patients as in those with other rheumatologic conditions.

Secondary symptoms of fibromyalgia may include:

  • Headaches, including migraines,
  • Facial or jaw pain
  • Digestive issues such as abdominal pain, bloating, constipation, irritable bowel syndrome (IBS)
  • Stiff muscles, numbness and tingling
  • Frequent urination
  • Dryness of mouth

Fibromyalgia diagnosis - tender points

Diagnosing fibromyalgia can be difficult and includes ruling out other possible causes of pain such as chronic fatigue syndrome, rheumatoid arthritis, and multiple sclerosis. Previously, 18 “tender points” around the body were often used as a tool in diagnosing fibromyalgia, but these points are no longer considered a reliable method of diagnosis.

What causes fibromyalgia - is it an auto-immune disease?

It’s not clear what causes fibromyalgia. However, current thinking in the field of rheumatology suggests that fibromyalgia may be caused by a problem with central pain processing in the brain, with an increased sensitivity or perception of pain to a given trigger.

There is a range of likely risk factors, including:

  • A stressful, traumatic physical or emotional event, such as a car accident
  • Repetitive injuries
  • Rheumatoid arthritis or other autoimmune diseases, such as lupus
  • Central nervous system (CNS) problems
  • The way our genes regulate how we process painful stimuli

For some, symptoms start to appear after a specific event, such as physical trauma, surgery, infection or significant psychological stress. For others, symptoms gradually appear and worsen without a triggering event. Women are more likely than men to develop fibromyalgia, and there is also a connection to other conditions such as tension headaches, temporomandibular joint (TMJ) disorders, IBS, anxiety and depression, but the connections are not fully understood.

The search for the cause of fibromyalgia has been difficult. Recent findings indicate that both an autoimmune reaction and an inflammation in the nerves could be the cause.

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What is the treatment for fibromyalgia?

At this time, there is no cure for fibromyalgia, but a range of medications and other treatments can help sufferers to manage symptoms. Lifestyle adjustments such as exercise, relaxation and stress-reduction can also help to alleviate the severity of symptoms.

How can I manage fibromyalgia pain?

There is a lot you can do to manage fibromyalgia pain, but it can take some time to figure out what works best for you and fits best with your lifestyle. With the help of a self-management tool such as Paindrainer, you can receive customized personal advice about how to optimize your daily activities so that you have energy to do what is of value to you.

Self-management of fibromyalgia pain can be done through:

Physical activity
Feeling pain for extended periods of time can make it tempting to avoid physical activity and become more sedentary, but that weakens muscles and decreases physical fitness. Physical activity is also great for mental wellbeing and improves sleep quality.

Walks, water aerobics and swimming are very good, gentle forms of activity. When introducing new physical activity, it’s best to gradually increase the duration and intensity of exercise. And remember - a ten-minute walk is better than no walk at all. Muscle soreness following physical activity is not a sign that something is wrong.

Good sleep is very important. Try to avoid sleeping or resting during the day as it disrupts night sleep. A doctor can help you to find a sleep aid that suits you if you need it.

Heat is a good temporary pain reliever. A heat pad or a warm shower or bath can help lessen pain, relieve stiffness, and help you to relax.

Additional things you can do to help you live better with fibromyalgia include:

  • Relaxation, TENS, Massage, and mindfulness
  • Cognitive Behavioral Therapy (CBT)
  • Yoga
  • Acupuncture

In Paindrainer you will get access to a set of relaxation and mindfulness exercises, designed by pain management experts specifically tailored for home use to help you manage and alleviate your pain.

Fibromyalgia diet - can eating differently ease my symptoms?

There is no one fibromyalgia diet, but a balanced diet that promotes energy and wellbeing is always beneficial, and getting the right mix of nutrients including antioxidants and vitamin B12 is particularly important for people with fibromyalgia. Maintaining a moderate weight is also important. In addition, since fibromyalgia can leave you feeling low in energy, slowing down the absorption of carbohydrates by combining them with proteins or healthy fats, and avoiding sugary foods, can help to maintain a steady energy balance.

Fibromyalgia diagnosis: I think I might have fibromyalgia - what do I do now?

If you think you might have fibromyalgia, begin by making an appointment to see your doctor. In the meantime, it is never a bad idea to start taking good care of your general health by staying active, prioritizing good sleep habits, and practicing self care to manage stress and promote wellbeing. New advancements chronic pain management can also help you to optimize how you live with chronic pain while maintaining an active lifestyle.




Clinical and experimental rheumatology

Fibromyalgia diagnosis

The 7 types of fibromyalgia pain

Fibromyalgia and depression

Fibromyalgia-related sleep disorder diagnosis and treatment tips

Fibromyalgia diet: Eating to ease symptoms

Fibromyalgia tender points: What and where are they?

Fibro Fog 

How to relieve fibromyalgia pain

Everything you need to know about fibromyalgia

What is known about the causes of fibromyalgia? 

People with fibromyalgia have inflammation of the brain 

Evidence for Abnormal Pain Processing in Fibromyalgia Syndrome
Roland Staud, MD, MaryAnn Domingo, MD
Pain Medicine, Volume 2, Issue 3, September 2001, Pages 208–215,
Published: 07 July 2008

Paindrainer is proven to help you manage your pain

Data for individuals with chronic back and neck pain using Paindrainer for 12 weeks.

Improved physical function*
Decreased pain intensity*
Decreased pain interference*
Increased daily capacity to work*

*Barreveld A.M.,et al,. Pain Med. (2023) Apr 27

User reviews

Many satisfied users benefit in understanding their pain and managing their daily lives

"By using Paindrainer, I've gained an understanding of what negatively affects my pain and what I need to do to take care of myself.

I've realized how important it is to sleep well, do things I enjoy, and incorporate rest into my daily life. It makes me feel better. Mentally, it's positive because I notice that days vary, and it gives me hope when the pain is at its worst.

Paindrainer is easy to use and has become like a friend I carry in my pocket, reminding me to be kind to myself."

- Maria

"Paindrainer has truly helped me create a more balanced daily routine and make conscious decisions to prioritize what is valuable for me and improve my well-being.

After just a week of using Paindrainer, I received recommendation to prioritize more sleep. Now, I've increased my sleep from 6 to 7 hours per night, which has really benefited me. In addition to sleep, Paindrainer made me aware that longer workout sessions were increasing my pain. As a result, I've adjusted my training to shorter sessions of no more than 20 minutes and added an extra training day per week instead, which suits me much better.

- Cecilia