Fibromyalgia: Your GoodRx Guide

Fibromyalgia affects about 5% of men and 8% of women in the U.S. It’s more common in people who have autoimmune conditions like lupus, but it can also occur by itself.

Living with fibromyalgia is challenging, and some days may be harder than others. This can feel discouraging. But there are many therapies that can help. The best treatments aren’t pills. In fact, they’re mind-body techniques and exercise. Sometimes, medications can help, too.

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What are the signs and symptoms?

The most common symptom of fibromyalgia is widespread pain throughout the body. The pain can occur anywhere. But it most often occurs in the:

• Neck

• Upper back

• Chest

• Buttocks

• Lower back 

Pain might feel sharp, achy, burning, or tingly. It typically affects many areas of the body at once, not just one. 

In addition to pain, other common fibromyalgia symptoms include:

• Stiffness of the joints and muscles

• Tenderness of the body to light touch

• Trouble falling asleep or staying asleep

• Fatigue and exhaustion (despite getting enough sleep)

• “Brain fog,” which might include trouble with memory, finding words, concentration, and/or slowed thinking

• Trouble with body temperature (feeling too hot or too cold)

• Body swelling

People with fibromyalgia commonly have other health conditions, too. Examples include:

• Depression and/or anxiety

• A history of trauma (physical or emotional)

• Migraines

• Irritable bowel syndrome (IBS)

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Causes

Scientists don’t know exactly what causes fibromyalgia. But they believe that many different factors contribute to it. Women are more likely to get fibromyalgia than men, but anyone can get it.

As a central sensitization syndrome, the brain plays a big role in fibromyalgia. Studies show that in people with fibromyalgia, the brain processes pain differently. You might think of it like cranking up the volume on a radio. In fibromyalgia, the brain makes pain signals louder. That’s why touch that normally doesn’t feel painful can feel painful for people with fibromyalgia. 

Certain genes (what we inherit from our birth parents) also increase the risk of developing fibromyalgia. That’s why people who have close relatives (parents or siblings) with fibromyalgia are more likely to get it. The idea is that some people have a genetic predisposition to high pain sensitivity. When they are exposed to stressful life triggers, fibromyalgia occurs. This could include physical stress, such as infection, inflammatory disease, or injury. Or it could include emotional stress, like harmful childhood experiences. More research is needed to confirm this theory.

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How do you test for fibromyalgia?

Unfortunately, there is no single test to diagnose fibromyalgia. Providers use a combination of symptoms and physical exam to diagnose it. Symptoms must be present for at least 3 months. Blood tests or imaging are typically not necessary for diagnosis. Sometimes they may be ordered to rule out other conditions, though.

The American College of Rheumatology has developed criteria that help providers diagnose fibromyalgia. These include a variety of questions about the location and severity of pain, as well as other symptoms.

Treatments

There might not be a cure for fibromyalgia, but there’s hope. There are a lot of treatments that can help decrease pain and fatigue, improve quality of life, and improve level of function.

Non-medication therapies are offered first because studies show they work. Options include:

• Gentle exercise (like walking 30 minutes per day) to relieve pain

• Tai chi

• Cognitive behavioral therapy (CBT), a type of talk therapy that helps people with chronic pain better cope with the symptoms they’re experiencing

Stress reduction and getting more sleep may also help relieve symptoms. More on this below.

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Medications

If non-medication therapies aren’t enough, medications may reduce pain by about 30% in some people. But they are not likely to help if used alone. In other words, they work in combination with the treatments listed above. FDA-approved options include:

• Pregabalin (Lyrica)

• Duloxetine (Cymbalta)

• Milnacipran (Savella)

Other medications that aren’t FDA-approved may be prescribed off-label (using a medication for a different condition than what it was approved for). These include:

• Amitriptyline

• Gabapentin

• Cyclobenzaprine (Flexeril)

Studies have shown that the following medicines do not help:

• Acetaminophen (Tylenol)

• Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen

• Steroids (like prednisone)

• Opioids (like morphine and oxycodone); these may actually make fibromyalgia symptoms worse

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Living with fibromyalgia

It’s common to experience anxiety or depression when you live with severe pain every day. And this can make the physical pain feel worse. With help from a mental health specialist, medications and talk therapies can improve both your mood and the pain. 

Lifestyle habits also play an important role in mental health and fibromyalgia. For example, sleep quality, lowering stress levels, and education about fibromyalgia are all important when it comes to feeling your best. Yoga and acupuncture may help, too.

If you’re interested in learning more about support groups and ways to improve fibromyalgia, check out the resources at the National Fibromyalgia Association and Support Fibro. 

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