Fibromyalgia symptoms include fatigue and chronic pain from “tender points”—places on the neck, shoulders, back, hips, arms, and legs that hurt when touched.

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What is fibromyalgia? Fibromyalgia is viewed as a rheumatic condition (like arthritis), even though it doesn’t cause inflammation or joint damage. Hallmark fibromyalgia symptoms include fatigue and chronic pain from “tender points”—places on the neck, shoulders, back, hips, arms, and legs that hurt when touched.

Other fibromyalgia symptoms include trouble sleeping, morning stiffness, headaches, and irritable bowel syndrome as well as restless legs syndrome, depression, and problems with thinking and memory (often described as “fibro-fog”).

Because there is no lab test for fibromyalgia, and the symptoms of fibromyalgia are often vague, many people wait a year or longer for a diagnosis. In one national survey, 25 percent of the respondents said they suffered fibromyalgia symptoms for at least five years before being diagnosed. Early diagnosis is important in fibromyalgia, because patients diagnosed within a year of developing the condition are less likely to experience severe symptoms of fibromyalgia.

To meet the American College of Rheumatology’s criteria for a diagnosis of fibromyalgia, a patient has to have widespread pain affecting the left, right, top, and bottom of their body for longer than three months, with no underlying disorder that would otherwise explain the pain. Your doctor also may apply pressure to areas of the body that typically are tender points.

What Causes Fibromyalgia?

There is no clearly defined cause for fibromyalgia, although certain factors raise your risk for the condition. For example, you are more likely to develop the symptoms of fibromyalgia if you have arthritis in your spine, rheumatoid arthritis, or lupus, or if you have suffered trauma (such as an injury, surgery, or emotional upset).

Fibromyalgia symptoms also may be linked to problems in the central nervous system, and problems with the way the brain processes pain signals coming from the nerves. There also may be a genetic element, since studies show that people who have relatives with fibromyalgia are more likely to develop fibromyalgia symptoms.

Fibromyalgia Treatment

Doctors will prescribe various medications to treat fibromyalgia symptoms, including standard painkillers. Opioids are not used, since fibromyalgia symptoms are chronic, and opioids can be addictive. Other than painkillers, your doctor may prescribe antidepressants as a fibromyalgia treatment—the primary options are milnacipran (Savella), and duloxetine (Cymbalta)—and anti-seizure drugs such as pregabalin (Lyrica) and gabapentin (Neurontin).

Lifestyle changes also can go a long way toward relieving the pain and fatigue of fibromyalgia. Self-help strategies for fibromyalgia treatment include:

• Physical activity. Many studies have shown that different types of exercise can help people with fibromyalgia symptoms. Activities as diverse as aerobics, Nordic walking, yoga, tai chi, strength training, water exercises, and just plain walking can be helpful. However, it’s important to work with your doctor or other health professional to set up a program that starts very slowly (such as walking five minutes three days a week), and progressing gradually from there.
• Stress management. Since stress aggravates the symptoms of fibromyalgia, try to identify a stress-management technique that works for you, whether it’s meditation, yoga or a massage, or going out to lunch with friends.
• Plan. Plan strenuous activities so they can be done in phases; for example, instead of cleaning the house for an entire morning, do a few smaller cleaning tasks on Monday, Tuesday, and Wednesday so that you’re not overwhelmed.
• Eat well. Following a healthful diet is important, so if you’re not eating well, consider taking a multivitamin. Although some people take fish oil as an anti-inflammatory, it’s not clear that fibromyalgia is truly an inflammatory condition like lupus or rheumatoid arthritis—there’s really no specific supplement to take.
• Sleep well. Establish a set sleep routine. Getting enough sleep is important for overall physical and mental wellbeing.

Originally published in April 2016 and updated.