5 Ways to Manage Fibromyalgia Symptoms

It’s not completely understood why. Some doctors believe that, due to the pain of these conditions, the body eventually forgets how to "shut off" pain, leading to more widespread pain that’s characteristic of fibromyalgia. “For some people, they don't have any sort of triggering trauma before developing fibromyalgia, while others may have an underlying painful diagnosis that then evolves into fibromyalgia,” Mandelin says.

Here’s what to know about fibromyalgia, including how to manage its symptoms if you have it.

What Is Fibromyalgia?

Fibromyalgia is a condition that causes people to be more sensitive to pain, called abnormal pain perception processing, according to the CDC. Symptoms of fibromyalgia include fatigue, sleep problems, difficulty concentrating, and mental and emotional distress.

It isn't clear what causes fibromyalgia. However, the condition is twice as common in women as it is in men, and it may be hereditary. Emotional and mental conditions such as anxiety, depression, and post-traumatic stress disorder (PTSD) are also strongly associated with it, according to the Cleveland Clinic.

How Do You Know If You Have Fibromyalgia?

Fibromyalgia can be difficult to diagnose because there’s no test to detect it. “So, it's purely a clinical diagnosis," Mandelin says. Doctors first have to rule out other health conditions that can be diagnosed with a test, such as arthritis or anemia. Fibromyalgia lacks inflammatory features that other conditions may have, says Nilanjana Bose, M.D., a board-certified rheumatologist with Memorial Hermann, in Houston.

When a person still experiences widespread pain that’s unconfirmed by other diagnostic tests—and meets certain criteria, like pain on both sides of the body—that may point to fibromyalgia.

Strategies for Managing Fibromyalgia Symptoms

Fibromyalgia currently has no cure, but a combination of medication and lifestyle strategies can help people manage fibromyalgia symptoms.

• Medication: There are three drugs specifically approved by the Food and Drug Administration (FDA) for the treatment of fibromyalgia, according to Mandelin: duloxetine (Cymbalta), milnacipran (Savella), and pregabalin (Lyrica). Pregabalin is an anti-seizure drug that may relieve anxiety, pain, and sleep issues. Duloxetine and milnacipran are drugs that affect certain brain chemicals involved in pain perception and mood. Other drugs may be used off-label to address the symptoms of fibromyalgia. These may include pain relievers, anticonvulsants, muscle relaxants, antidepressants, and sleep aids. Any of these medications need to be used under a doctor's supervision, Bose says.
• Counseling: Psychotherapy may help reduce a person’s perception of pain and improve their quality of life, according to a 2021 review that examined studies on fibromyalgia and a type of psychotherapy called cognitive behavioral therapy.
• Physical therapy: “Physical therapy can be very useful for range of motion and mobility preservation,” Mandelin says. Be sure to look for a physical therapist who has experience treating people with chronic pain, who’ll likely be more knowledgeable about how not to push you too much, he adds.
• Exercise: Physical activity is crucial to staying well and reducing fatigue and pain with fibromyalgia, according to the American College of Rheumatology. Start slowly and build up. You could try walking more, and then as your pain levels decrease (such as with medication), you can add more exercise. Tai chi, in particular, may be beneficial to people coping with fibromyalgia pain. Research suggests that yoga is another helpful option, as well.
• Other lifestyle strategies: Both massage therapy and acupuncture may help some people with fibromyalgia find relief, says the Arthritis Foundation. It's also important to get as much good sleep as you can. Try to get up at the same time each morning, even on the weekends or days off. This helps maintain your sleep-wake cycles (circadian rhythm), which can help you to sleep at night, too. If you have trouble sleeping at night, talk to your doctor for other strategies or evaluation.

If you live near a pain clinic, that can be a great option, as well, Mandelin says. Pain clinics offer access to different specialized health professionals who help treat pain comprehensively. In addition to physicians, a pain clinic’s care team may include physical and occupational therapists, mental health professionals, and complementary and alternative therapy practitioners who follow approaches that are safe to use with Western medicine, Mandelin adds.

There are also herbal or natural supplements that are supposed to treat fibromyalgia, such as Chinese herbal medicine, though Mandelin warns against them. "The reason for that is not that they don't work—sometimes they do," he says. But herbs and supplements aren’t regulated by the FDA. Since these mixtures can be different each time, it can be hard to know what in them may be helping you, or if an herb may interact with a drug you're taking.

Other options that aren’t recommended for fibromyalgia pain? Nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and opioids, which are all generally ineffective at managing pain from fibromyalgia.

Each person with this condition is different, so work with your doctor to find the right combination of medication and lifestyle treatments that will help manage your fibromyalgia symptoms and ease your pain.

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