Fibromyalgia: Symptoms, Diagnosis and the Treatments With the Best Evidence

Fibromyalgia is a long-term condition that causes pain all over the body, along with extreme tiredness, poor sleep and problems with memory and concentration. Blood tests and scans are usually normal, which can leave people feeling disbelieved, but the condition is real and there is a lot that helps.

Imagine aching from head to toe, sleeping badly every night and being told every test is normal. Getting a diagnosis can be a relief, because it means a plan, starting with gentle steps that build strength rather than rest that makes things worse.

Common symptoms

• Widespread pain, often described as aching, burning or stabbing
• Extreme tiredness (fatigue) and unrefreshing sleep
• Muscle stiffness
• Problems with memory and concentration, often called “fibro fog”
• Sensitivity to pain, temperature, noise or bright light
• Headaches, irritable bowel symptoms, anxiety or low mood

How it is diagnosed

There is no single test. A doctor diagnoses fibromyalgia from your symptoms, how long they have lasted and an examination, and may order tests to rule out other conditions such as an underactive thyroid or inflammatory arthritis.

Treatments with the best evidence

• Exercise: regular aerobic and strengthening exercise, built up slowly, has the strongest evidence
• Talking therapies such as cognitive behavioural therapy, to manage pain and sleep
• Good sleep habits and pacing your activities
• Some medicines, such as certain antidepressants used for pain, prescribed by a doctor

But won’t exercise make the pain worse?

At first it can feel that way, which is why the key is starting very gently and building up slowly, such as a few minutes of walking or swimming. Over weeks, regular activity usually reduces pain and tiredness. A physiotherapist can help you plan it.

Sources: NHS, “Fibromyalgia”; NICE guideline NG193, “Chronic pain (primary and secondary) in over 16s”; US Centers for Disease Control and Prevention (CDC), “Fibromyalgia”. This guide is for general information and does not replace advice from your own nurse, doctor or pharmacist.