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(FM; Fibromyalgia Syndrome; FMS)

Pronounced: FI-bro-my-OWL-jah

En Español (Spanish Version)More InDepth Information on This Condition


Fibromyalgia is a complex, chronic, and disabling disorder. It causes widespread pain and stiffness in the muscles, tendons, and ligaments, along with poor sleep and fatigue.

Fibromyalgia Trigger Points

© 2008 Nucleus Medical Art, Inc.


The exact cause is unknown.

The following conditions are commonly associated with fibromyalgia:

Risk Factors

A risk factor is something that increases your chance of getting fibromyalgia. Risk factors include:

  • Sex: female
  • Age: 20-60 years old
  • Physical or mental stress
  • Physical trauma (eg, accident, injury, or severe illness)


Common symptoms include:

  • Generalized fatigue or tiredness
  • Reduced physical endurance
  • Generalized aches and pains of muscles, tendons, and ligaments
  • Muscle tightening or spasms
  • Pain in specific areas of the body, especially:
    • Neck
    • Shoulders
    • Chest
    • Back (upper and lower)
    • Hips and thighs
  • Insomnia or poor sleep
  • Sensations of numbness or swelling (although swelling is not actually present)
  • Chronic headaches, including migraines
  • Morning stiffness, worst on first arising

Factors that may trigger or worsen symptoms include:

  • Weather changes, especially cold, damp weather
  • Stress or anxiety
  • Overexertion
  • Medical illness
  • Surgery


The doctor will ask about your symptoms and medical history, and perform a thorough physical exam. There are no specific tests for this condition.

The doctor will look for the following signs:

  • Widespread pain lasting three months or longer
  • Tenderness (on physical exam) in at least 11 of 18 specific areas of the body


The goal of treatment is to relieve or control the symptoms. Treatments include:

Physical and Behavioral Therapies

Lifestyle Changes

  • Eating a healthful diet
  • Learning to cope with physical and mental stress
  • Regular, moderate, low-impact exercise with your doctor's approval
    • Try gentle exercise that does not strain painful areas, such as:
      • Walking
      • Biking
      • Swimming, preferably in warmer water
  • Regular stretching exercises
  • Maintaining a regular sleep schedule

A team of experts studied fibromyalgia and recommended the following:

  • Approach that focuses on medication and other treatments
  • Heated pool treatments with or without exercise
  • Individual exercise programs
  • Cognitive behavioral therapy and other forms of counseling
  • Other therapies (eg, massage, relaxation, physical therapy)
  • Tramadol , paracetamol, or other weak opioids
  • Antidepressants (eg, amitriptyline , fluoxetine , duloxetine , milnacipran, moclobemide , pirlindole)
  • Medications for pain relief (eg, tropisetron, pramipexole , pregabalin )


Since the cause is unknown, there are no guidelines for preventing fibromyalgia.


The American Fibromyalgia Syndrome Association, Inc. /

National Fibromyalgia Partnership, Inc.


The Arthritis Society

Fibromyalgia Information and Local Support


Berkow R. The Merck Manual of Medical Information . New York, NY: Pocket; 2000.

Carville SF, Arendt-Nielsen S, Bliddal H, et al. EULAR evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis . 2008;67:536-541.

Edema. Cleveland Clinic website. Available at: . Updated November 2005. Accessed June 19, 2008.

Fibromyalgia. EBSCO DynaMed website. Available at: . Updated June 2008. Accessed June 19, 2008.

Fibromyalgia. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: . Updated August 2007. Accessed June 19, 2008.

Fibromyalgia update. Bandolier website. Available at: .

Myofascial pain syndrome. Mayo Clinic website. Available at: . Updated May 2007. Accessed June 19, 2008.

Paresthesias. MedHelp website. Available at: . Accessed June 19, 2008.

Periodic limb movement disorder (PLMD) or nocturnal myoclonus. Eastern Virginia Medical School website. Available at: . Updated March 2006. Accessed June 19, 2008.

Last reviewed May 2008 by John C. Keel, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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