--- title: "Fibromyalgia: Symptoms, Causes & Treatment | HealthAnswers" description: "Fibromyalgia — widespread pain, fatigue, and brain fog explained: diagnosis, NHS treatments, and distinguishing from other conditions." url: https://healthanswers.co.uk/conditions/fibromyalgia/ robots: noindex --- # Fibromyalgia: Symptoms, Causes & Treatment | HealthAnswers Health A–Z Fibromyalgia — widespread pain, fatigue, and brain fog explained: diagnosis, NHS treatments, and distinguishing from other conditions. Written by HealthAnswers editorial team Medically reviewed by [HealthAnswers UK doctor review panel](https://healthanswers.co.uk/our-doctors/) Reviewed 3 July 2026 ## Quick answer What is fibromyalgia? Fibromyalgia causes widespread musculoskeletal pain, extreme fatigue, unrefreshing sleep, and cognitive difficulties ("fibro fog") — often alongside headaches and irritable bowel symptoms. Diagnosis is clinical — no single blood test — after excluding other conditions. Treatment combines exercise, psychological support, and medicines like amitriptyline or duloxetine for pain and sleep. See a GP if pain is widespread on both sides of the body for 3+ months. ## Who is this page for? This page is for people in the UK who want a plain-English overview of Fibromyalgia, including when to seek help and what NHS care usually involves. It explains general information, not what is wrong with you personally. ## Who should skip this page? Skip this page if you need a diagnosis, a prescription, or emergency care. It cannot replace a GP, pharmacist, NHS 111 or 999. If you are in immediate danger, call 999; for urgent advice that is not life-threatening, call 111 in England, Scotland or Wales, or use your GP out-of-hours service in Northern Ireland. On this page 7 sections ## Key facts about fibromyalgia - Fibromyalgia affects roughly 1 in 20 people — mainly women, often diagnosed aged 30 to 50. - Pain is widespread above and below the waist, on both left and right sides, for at least 3 months. - Normal blood tests — diagnosis excludes thyroid disease, anaemia, inflammatory arthritis, and vitamin D deficiency. - Graded exercise and CBT have the strongest evidence — not bed rest. - Often overlaps with IBS, migraine, anxiety, and chronic fatigue presentations. ## Fibromyalgia — chronic widespread pain **Fibromyalgia** is a **chronic condition** causing **widespread pain**, **profound fatigue**, **poor sleep**, and **cognitive difficulties** — often called **“fibro fog”**. It affects an estimated **2 to 4% of adults** in the UK — **women more than men**. It is **real, disabling**, and **not “all in the mind”** — but it is **not inflammatory** like [rheumatoid arthritis](https://healthanswers.co.uk/conditions/rheumatoid-arthritis/) — joints and organs are not damaged by the disease itself. ## Core symptoms **Widespread pain:** - both sides of body - above and below waist - axial skeleton — neck, back, chest - persists ≥3 months - burning, aching, stabbing quality - allodynia — tenderness to light touch **Fatigue:** - not relieved by rest - post-exertional worsening common **Sleep:** - unrefreshing sleep — wake exhausted - alpha-delta sleep anomaly described in research **Cognitive:** - poor concentration, word-finding difficulty, memory complaints **Associated (common):** - headache , migraine - IBS symptoms - anxiety and depression - temporomandibular joint pain - ** restless legs** sensations ## Diagnosis — exclusion and pattern **No single test.** GP assesses and orders: - FBC — exclude anaemia - TSH — exclude thyroid disease - CRP/ESR — exclude inflammatory arthritis - vitamin D if deficient risk - consider coeliac if bowel symptoms **2016 ACR criteria** (simplified clinically): widespread pain index + symptom severity — GP or rheumatology applies. **Do not label prematurely** — investigate red flags (weight loss, focal neurology, inflammatory markers high). ## What fibromyalgia is not - Not joint inflammation — unlike RA - Not progressive organ damage - Not laziness or malingering - Not cured by single blood test or scan ## Treatment — multimodal approach ### Exercise — cornerstone **Graded activity** — start low, increase slowly: - walking, swimming, cycling - strength training — improves function in trials - avoid boom-bust — crashing after overactivity Physiotherapy referral helps pacing. ### Psychological support **CBT**, **acceptance and commitment therapy (ACT)** — improve coping and function — not “because it’s psychological” but because **pain neuroscience** involves brain processing. ### Sleep hygiene Regular schedule, limit caffeine/alcohol, CBT for insomnia — see [insomnia](https://healthanswers.co.uk/conditions/insomnia/). ### Medicines (symptom relief — not cure) | Medicine | Role | | --- | --- | | Amitriptyline (low dose) | Pain, sleep | | Duloxetine | Pain, mood | | Pregabalin/gabapentin | Pain — NICE chronic pain guidance limits use — discuss risks | | Tramadol/opioids | Avoid long term — poor benefit-harm ratio | No single drug works for everyone — trials often needed. ### Self-management - Fibromyalgia Action UK — support groups - workplace adjustments — flexible hours - pain management programmes — NHS multidisciplinary ## Overlap with other conditions Many patients also have: - [IBS](https://healthanswers.co.uk/conditions/irritable-bowel-syndrome/) - [migraine](https://healthanswers.co.uk/conditions/migraine/) - [depression/anxiety](https://healthanswers.co.uk/conditions/depression/) Treat holistically — not siloed. ## Prognosis **Chronic but fluctuating** — not life-shortening. Many improve function with **consistent pacing and exercise** — rarely “disappears completely.” **Avoid:** - prolonged bed rest - chasing unproven expensive tests - doctor shopping for structural diagnosis missing Fibromyalgia requires **patience, multidisciplinary care, and activity pacing** — validation and structured rehabilitation beat repeated scans showing nothing. ## ! When to see a GP about fibromyalgia See a GP for persistent widespread pain and fatigue affecting daily life — especially with unrefreshing sleep and concentration problems. Same assessment excludes treatable causes (thyroid, anaemia, rheumatoid arthritis). Seek support if low mood or anxiety develop — common and treatable alongside fibromyalgia management. ## Common questions about fibromyalgia What are the symptoms of fibromyalgia? Widespread aching pain lasting 3+ months, severe fatigue, waking unrefreshed despite sleep, memory and concentration problems (fibro fog), headaches, irritable bowel symptoms, and sensitivity to touch — even light pressure hurts (allodynia). Symptoms fluctuate — good and bad days. What causes fibromyalgia? Unknown — central nervous system pain processing appears amplified — brain and spinal cord intensify pain signals. Triggers include physical trauma, surgery, infection, or emotional stress in some people. Not inflammatory arthritis — joints are not damaged. Is there a test for fibromyalgia? No definitive test — GP diagnoses after history, examination, and blood tests excluding other conditions (thyroid, inflammatory markers, vitamin D, anaemia). Tender points are less emphasised now — widespread pain and associated symptoms define diagnosis. What helps fibromyalgia pain? Paced graded exercise (walking, swimming, strength training started gently), CBT or ACT psychological therapy, sleep hygiene, and medicines — amitriptyline, duloxetine, pregabalin — for some people. Opioids generally not recommended long term. Is fibromyalgia the same as chronic fatigue syndrome? Overlapping conditions — both feature fatigue and pain. CFS/ME emphasises post-exertional malaise (crash after activity). Many people meet criteria for both — management overlaps with pacing and holistic support. ## Sources - [NHS — Fibromyalgia](https://www.nhs.uk/conditions/fibromyalgia/) - [NICE — Chronic pain guideline](https://www.nice.org.uk/guidance/ng193)