Fibromyalgia: symptoms, diagnosis, causes and treatment

The NHS says fibromyalgia has many symptoms that tend to vary from person to person. The main symptom is widespread pain, which may be felt throughout the body but could be worse in particular areas such as the back or neck. It is likely to be continuous, although it may be better or more severe at different times, and may feel like an ache, a burning sensation or a sharp, stabbing pain.

Arthritis UK points out that, unlike arthritis, the pain is not because of problems with your joints, bones or muscles. It adds that fatigue is often described as the worst part, alongside difficulty thinking clearly.

Arthritis UK describes fibromyalgia as a long-term condition that causes pain and tenderness all over the body. It is thought to be caused by the nervous system in the brain and spine not being able to control or process pain signals from other parts of the body. The NHS describes it as being related to changes in the way the central nervous system processes pain messages.

Arthritis UK is clear that fibromyalgia does not seem to cause long-term damage to the body, and that the fact there is no visible inflammation or damage does not mean the symptoms are unreal or all in the mind.

The NHS says treatment aims to ease symptoms and improve quality of life. No single treatment works for all symptoms, so you may need to try a variety to find a combination that suits you. Your GP can help you decide, depending on what you prefer and what is available in your area.

Arthritis UK says keeping active is an important part of treatment, and that a mix of aerobic exercise (swimming is recommended), strengthening and stretching can help. It stresses pacing: balancing activity with rest so you do not overdo it on good days or feel worse after doing too much.

Because poor sleep appears to play a part, Arthritis UK suggests regular bed and wake times, a dark, quiet and comfortable bedroom, avoiding caffeine in the eight hours before bed and not using screens in the bedroom. It says sleeping tablets are not normally recommended.

Arthritis UK also notes that there is no particular diet that has been proven to help fibromyalgia, but it recommends keeping to a healthy weight with a balanced diet low in saturated fat, sugar and salt.

The NHS says diagnosing fibromyalgia can be difficult because there is no specific test and the symptoms vary and resemble other conditions. A GP will ask how symptoms are affecting your daily life and may examine you for signs of other conditions, such as swollen joints that suggest arthritis. Urine and blood tests may be used to check for other conditions, and you may also have X-rays or scans.

Arthritis UK says doctors look for severe pain lasting three months or more, fatigue, regularly waking unrefreshed and problems with memory and understanding. It says similar symptoms occur in rheumatoid arthritis, Sjögren disease and an underactive thyroid, and that you can have one of these conditions as well as fibromyalgia. A GP may refer you to a rheumatologist, physiotherapist, psychologist, occupational therapist or pain clinic.

The NHS says the exact cause is unknown, but a number of factors are likely to be involved. One of the main theories is changes in how the central nervous system processes pain messages. Genetics may play a small part, which could explain why many people develop it after some sort of trigger.

Possible triggers listed by the NHS include a serious injury such as a car accident, an infection such as Epstein-Barr virus or Lyme disease, a major operation, and significant emotional trauma. Sometimes there is no obvious trigger. The NHS also notes that rheumatic conditions such as osteoarthritis, rheumatoid arthritis and ankylosing spondylitis are often associated with fibromyalgia.

The NHS says anyone can develop it, but it is more common in women than in men, and it typically develops between the ages of 25 and 55. It is not clear exactly how many people are affected, partly because it can be hard to diagnose.

Arthritis UK says it is difficult to predict how long you will have the condition and what impact it will have, because symptoms vary. The NHS says treatment can ease symptoms, although they are unlikely to disappear completely.

The NHS says to see a GP if you think you have fibromyalgia. It also says that if you think you may be depressed, which can happen in some cases, it is important to get help from a GP or your fibromyalgia healthcare professional.

Arthritis UK says fibromyalgia can often be diagnosed and treated by your GP without seeing a specialist, and that your doctor can refer you to an NHS physiotherapist, an occupational therapist, a psychologist or a pain clinic when needed. A rheumatologist may confirm the diagnosis.

Arthritis UK notes that it can be quicker to see a physiotherapist or occupational therapist privately, but you would pay for the appointment. It suggests using the register of an appropriate professional body, such as the Chartered Society of Physiotherapy or the Royal College of Occupational Therapists, to find one.

The NHS says support groups can provide an important network for people living with fibromyalgia, and names Fibromyalgia Action UK as a charity offering information and support. Arthritis UK also suggests learning about the condition, talking with others and helping family and friends to understand how pain affects you even if you look well.