Fibromyalgia: symptoms, causes, treatment and which doctor to see
What fibromyalgia is, why it causes pain all over the body, how it is diagnosed when tests are normal, and the treatments that help most.
Also known as: Diffuse myofascial pain syndrome; FMS; Fibro; Fibromyalgia syndrome; Fibromyalgia-fibromyositis syndrome; Fibromyositis and 2 more
Fibrositis; Myofascial pain syndrome
What fibromyalgia is
Fibromyalgia is a long-term condition that causes pain and tenderness across many parts of the body, together with tiredness, poor sleep and problems with memory and concentration. It does not damage the joints, muscles or organs, and it does not shorten life. But it can make ordinary days — work, housework, travel, looking after children — very hard.
Research suggests that in fibromyalgia the brain and spinal cord process pain differently. The nervous system becomes over-sensitive, turning up the 'volume' on pain signals, so that pressure or movement that would not hurt most people does hurt. This is sometimes called central sensitisation. It means the pain is real, even though blood tests and scans look normal.
There is no cure at present, but many people improve substantially with the right combination of treatment and self-management. Symptoms often go up and down, with flares and better spells.
Symptoms
- Widespread pain — aching, burning or throbbing on both sides of the body, above and below the waist, lasting three months or more
- Stiffness, especially in the morning or after sitting still
- Fatigue that is not relieved by rest
- Unrefreshing sleep — waking up tired even after a full night
- Brain fog: trouble concentrating, remembering or finding words
- Headaches, including migraine
- Tingling or numbness in the hands and feet
- Sensitivity to noise, light, cold or touch
- Low mood or anxiety
Many people with fibromyalgia also have irritable bowel syndrome, jaw pain, painful bladder symptoms or painful periods. Stress, a physical illness, poor sleep, overdoing activity or changes in weather can trigger flares.
Causes and who is at risk
The exact cause is not known. Fibromyalgia tends to run in families, so genes probably play a part, with many small genetic differences each adding a little risk. Symptoms sometimes begin after a physical or emotional trigger, such as an injury, an infection, surgery, childbirth or a period of severe stress, but often there is no clear starting point.
Anyone can develop fibromyalgia, including children and men, but it is more common in:
- Women
- Middle-aged people, with risk rising with age
- People with other conditions such as rheumatoid arthritis, lupus, osteoarthritis or ankylosing spondylitis
- People with a close family member who has fibromyalgia
- People with depression, anxiety or a history of trauma
How it is diagnosed
There is no single blood test or scan for fibromyalgia, and it can take visits to several doctors before the diagnosis is made. A doctor diagnoses it from the pattern of symptoms: widespread pain for at least three months, together with fatigue, sleep problems and thinking difficulties, once other causes have been considered.
A physical examination checks the joints for swelling, the muscles for strength, and the nervous system. Blood tests help rule out conditions that can look similar, such as anaemia, inflammatory arthritis, lupus, muscle disease, and vitamin D or B12 deficiency. Thyroid function is usually checked because an underactive thyroid (hypothyroidism) can cause aches, tiredness and low mood. In fibromyalgia these tests are normal — but having them done is important, because some of those conditions need quite different treatment.
Fibromyalgia can also exist alongside another condition. Someone with rheumatoid arthritis, for example, can have pain from both, and good care treats each part.
Treatment
Treatment aims to reduce pain, improve sleep and energy, and help you do more of what matters to you. Most people do best with a combination, and the parts you do yourself tend to matter more than any single tablet.
Regular exercise
Regular exercise is one of the most effective treatments, even though it can feel impossible when everything hurts. The key is to start very gently — a few minutes of walking, stretching, water exercise, yoga or cycling — and build up slowly over weeks. Pain may increase a little at first; that does not mean you are causing harm. A physiotherapist can design a programme that suits you.
Sleep and pacing
A steady sleep routine — the same bedtime and waking time, a dark quiet room, less tea and coffee later in the day, and screens off before bed — can improve both sleep and pain. Pacing means spreading tasks through the day and week rather than doing too much on good days and crashing afterwards. If you snore heavily or stop breathing at night, tell your doctor, as sleep apnoea can worsen symptoms.
Psychological therapy
Cognitive behavioural therapy (CBT) and related approaches help people manage pain, stress, sleep and low mood. Being referred to a psychologist does not mean the doctor thinks the symptoms are imaginary. Relaxation techniques, mindfulness and support groups help some people too.
Medicines
Medicines can help some people, though they rarely remove pain completely. Your doctor may suggest certain antidepressants that also reduce pain and improve sleep, or medicines for nerve pain that calm overactive nerve signalling. Simple painkillers may help a little. Strong opioid painkillers are generally not recommended for fibromyalgia. Your doctor will usually start at a low dose and review regularly, and will stop a medicine that is not helping.
Many people try massage, acupuncture or traditional therapies. Some find them comforting as additions, but evidence is mixed. Be cautious about expensive products or programmes that promise to remove fibromyalgia, and tell your doctor about anything you take.
Living with fibromyalgia
- Keep a simple diary of symptoms, activity and sleep to spot your own triggers
- Plan flares in advance: know which tasks you can drop and who can help
- Talk to your family about the condition; it is invisible, and understanding at home makes a big difference
- At work, ask whether flexible hours, regular breaks or a better chair and desk set-up are possible
- Look after your mood: depression and anxiety are common and treatable
- Avoid relying on alcohol or sleeping tablets bought without a prescription
When to seek urgent help
Fibromyalgia itself is not an emergency, but new or different symptoms should not be put down to it automatically. Call 112 or 108, or go to the nearest emergency department, for chest pain, sudden weakness or numbness on one side of the body, a sudden severe headache, or fever with a stiff neck. If you are having thoughts of harming yourself, call 112 or go to the nearest emergency department; for support when you are not in immediate danger, Tele-MANAS, India's national mental health helpline, is on 14416.
See your doctor soon if you develop joint swelling, a rash, fever, weight loss, or weakness rather than pain — these point towards other conditions.
Which doctor to see
A general physician can often diagnose and manage fibromyalgia. A rheumatologist is worth seeing when the diagnosis is uncertain, when an inflammatory or autoimmune condition needs to be ruled out, or when symptoms are not improving. A rehabilitation physician or physiotherapist can guide an exercise programme, and a clinical psychologist can provide CBT.
You can find rheumatologists in Bengaluru, physiotherapists in Bengaluru or clinical psychologists in Bengaluru on The Doctor Index, each with a registration you can check.
Questions to ask at your appointment
- Have other causes of my symptoms been ruled out?
- What kind of exercise should I start with, and how quickly should I build up?
- Would a medicine help me, and what side effects should I watch for?
- Can I be referred for CBT or a pain management programme?
- How should I manage a flare?
Common questions
Questions people ask
- Is fibromyalgia a real disease?
- Yes. Fibromyalgia is a recognised medical condition in which the nervous system processes pain differently. Normal blood tests and scans do not mean the pain is imagined; they simply show that joints and muscles are not damaged.
- Does fibromyalgia get worse over time?
- Fibromyalgia does not damage joints or organs, and it is not considered a progressive disease. Symptoms often go up and down, and many people improve with exercise, better sleep and other treatment, though some have long-lasting symptoms.
- Can men and children get fibromyalgia?
- Yes. It is more common in women and in middle age, but men, teenagers and children can also develop it. In children, a paediatrician or paediatric rheumatologist should look carefully for other causes of pain first.
- Is fibromyalgia the same as arthritis?
- No. Arthritis involves inflammation or damage in joints, which can often be seen on examination, blood tests or X-rays. Fibromyalgia causes widespread pain without joint damage, although some people have both conditions together.
This condition is usually assessed by a rheumatologist. Every profile shows the doctor’s registration and what has been checked.
Rheumatologists in Bangalore
A few rheumatologists listed on The Doctor Index. They are shown because of their speciality, not a stated interest in Fibromyalgia; ask the clinic whether the doctor sees it.
Related conditions
- Ankylosing Spondylitis
- Arthritis
- Gout
- Juvenile Arthritis
- Lupus
- Osteoarthritis
- Psoriatic Arthritis
- Rheumatoid Arthritis
Practical reading
All postsSources
- MedlinePlus, US National Library of Medicine — Fibromyalgia
- MedlinePlus Genetics — Fibromyalgia
- Government of India — Emergency Response Support System (112)
- MedlinePlus, National Library of Medicine — Fibromyalgia — Public-domain health-topic summary
- MedlinePlus Genetics — Fibromyalgia — Public-domain Genetics summary
Fibromyalgia: symptoms, causes, treatment and which doctor to see is original text by The Doctor Index; the compiled source draft was used for research. Source: MedlinePlus, National Library of Medicine. Orphadata Science: Free access data from Orphanet. © INSERM 1999; July 2026 data, CC BY 4.0. This product uses the Human Phenotype Ontology (hp/releases/2026-09-01). Only sources listed for this article apply. Source material has been selected and arranged; HPO definitions are reproduced without alteration. No source organisation endorses this compilation. Köhler S et al. The Human Phenotype Ontology project: linking molecular biology and disease through phenotype data. Nucleic Acids Research 2014;42(D1):D966–D974. doi:10.1093/nar/gkt1026.
General information, not advice about your situation. Errors can be reported through the corrections process. Reference TDI-C-0934.