Fibromyalgia - Treatment 

Treating fibromyalgia 

There is no cure for fibromyalgia, but treatment aims to ease your symptoms and improve your quality of life.

Your treatment will be decided between you and your GP, depending on what you prefer and what is available. Several different healthcare professionals may also be involved, such as:

  • a rheumatologist (a specialist in conditions which affect muscles and joints)
  • a neurologist (a specialist in conditions of the central nervous system)

As fibromyalgia has a number of different symptoms, no single treatment will work for all of them. You will need to try a variety of treatments to find a mix that suits you. This will normally be a combination of medication and lifestyle changes.

Information and support

You may find it helpful to research fibromyalgia to improve your understanding of the condition. Many people also find support groups helpful. Just talking to someone who knows what you are going though can make you feel better.

You can visit UK Fibromyalgia's support group section for a list of fibromyalgia support groups across the country.

Medicines for fibromyalgia

You may need to take several different types of medicines for fibromyalgia, including painkillers and antidepressants. Different medicines are described in more detail below.

Painkillers

If you have fibromyalgia, you can treat your pain using simple painkillers, such as paracetamol, available over the counter from a pharmacy. Always read the manufacturer’s instructions.

If paracetamol is not effective, your GP (or another healthcare professional treating you) may prescribe a stronger painkiller, such as codeine or tramadol. Research has found that tramadol can improve pain and may also help you function better in your daily activities.  

Side effects of tramadol include:

  • diarrhoea 
  • fatigue (extreme tiredness)
  • withdrawal symptoms if you stop taking it

Antidepressants

Antidepressant medicines for fibromyalgia are not prescribed specifically to treat depression. They are used to boost the levels of certain neurotransmitters, such as serotonin, noradrenaline and dopamine. Neurotransmitters are chemicals that carry messages to and from the brain.

It is thought that low levels of neurotransmitters may be a factor in causing fibromyalgia, and that raising their levels may help to treat the condition and ease pain.

There are different types of antidepressants. The choice of medicine will depend on the type of fibromyalgia you have, the severity of your symptoms and any side effects the medicine may cause.

Antidepressants used to treat fibromyalgia include:

  • tricyclic antidepressants - such as amitriptyline, which raises levels of serotonin and noradrenaline 
  • serotonin-noradrenaline reuptake inhibitors - such as duloxetine, which raise levels of serotonin and noradrenaline
  • selective serotonin reuptake inhibitors (SSRIs) - such as fluoxetine and paroxetine, which raise levels of serotonin

There are also two other types of medicine that affect the levels of neurotransmitters and are sometimes used :

Antidepressants can cause a number of side effects, including:

  • nausea (feeling sick)
  • dry mouth
  • dizziness
  • disturbed sleep
  • constipation (feeling unable to empty your bowels)

For more information on the side effects of your particular medication, see the patient information leaflet that comes with it, or read our Medicines info page.

Medicines to help you sleep

As fibromyalgia can affect your sleeping patterns, you may wish to try medicines to help you sleep. If you are sleeping better, you may find that your other symptoms are not as severe.

Speak to your GP if you think you could benefit from a medicine to help you sleep. They may recommend an over-the-counter medicine, or prescribe a short course of a stronger medication.

Read more information on treating insomnia including good sleeping techniques and medicines to help you sleep.

Muscle relaxants

If you have muscle stiffness or spasms (when the muscles contract painfully) as a result of fibromyalgia, your GP may prescribe a muscle relaxant to ease your symptoms. These medicines may also help you sleep more deeply at night because they can have a sedative (sleep-inducing) effect.

Anticonvulsants

You may also be prescribed an anticonvulsant (anti-seizure) medicine, as these can be beneficial in treating fibromyalgia.

The most common anticonvulsant used for fibromyalgia is pregabalin, which is normally used to treat epilepsy (a condition that causes seizures). One review of research into pregabalin found that 40% of people who used it for fibromyalgia reported feeling ‘much or very much’ improved.

You may be able to take pregabalin as a brand called Lyrica. Possible side effects include:

  • dry mouth
  • constipation
  • nausea
  • vomiting
  • dizziness
  • blurred vision
  • weight gain

Antipsychotics

Antipsychotic medicines, also called neuroleptics, are sometimes used to treat conditions that cause chronic (long-term) pain, such as fibromyalgia. Their effectiveness is not clear.

You may also be prescribed an antipsychotic as a pain reliever.

 Possible side effects include:

  • drowsiness
  • tremors (shaking)
  • restlessness

Other treatment options

Other treatment options which can be used to help cope with the pain of fibromyalgia include:

  • swimming, sitting or exercising in a heated pool or warm water
  • an individually tailored exercise programme (see Fibromyalgia - self-help for more information)
  • cognitive behavioural therapy (CBT) - a talking therapy that changes the way you think about things so you can deal with problems more positively
  • psychotherapy - a talking therapy that helps you understand and deal with your thoughts and feelings
  • relaxation techniques (see Fibromyalgia - self-help for more information)
  • physiotherapy - techniques such as massage are used to improve physical problems, such as muscle stiffness or weakness
  • psychological support - any kind of counselling or support group that helps you deal with the issues caused by fibromyalgia 

Read more information on self-help for fibromyalgia.

Alternative therapies

Some alternative therapies, such as acupuncture (where thin needles are inserted into certain points around the body to help relieve pain), claim to relieve or prevent fibromyalgia symptoms. So far, there is a lack of evidence supporting their effectiveness.

Until more research has verified that alternative therapies may have some benefit, they are not recommended for treating fibromyalgia.

Research into some complementary medicines, such as plant extracts, has found that they are not effective for fibromyalgia. If you decide to use any complementary or herbal remedies, check with your GP first. Some remedies can react unpredictably with other medication, or make it less effective.

Treating other conditions

If you have been diagnosed with another condition as well as fibromyalgia, such as depression, you may be recommended separate treatment including additional counselling or medication. 

Last reviewed: 05/04/2012

Next review due: 05/04/2014

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smarty88 said on 22 May 2013

Hi shale79 I had similar problems with pain and was suggested to try a dairy free diet for a month it didn't work for me, so my doctor suggested a wheat free diet also for a month and lo and behold about 2 and a half weeks into it, it started working, it helped so much. Although I am chronically ill I didn't realize that wheat was aggravating my symptoms and causing so much unnecessary pain and stiffness. Also I'm on Amitriptyline which I was dead against as I'm not depressed, but at my wits end with pain gave it a go and it worked for me it helps with pain from nerve issues. I hope this helps.

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shale79 said on 08 February 2013

iv had a pain in my neck for 2 years now its spread to my shoulders chest and upper back and down both arms on bad days i cant turn my head or lift my arms up to brush my hair or teeth, i cant do my daughters hair either its too painfull. iv been hosptial had xrays they couldt find nothing wrong keep giving me stronger and stronger pain killers which make me tired and dry mouth. the pain is agony during the night i have to get out of bed. iv got to go back to doctors and demand ,ore tests im sick of being fobbed off with stiff neck, pulled muscle, trapped nerve. im 33 and some days cant hardley move i feel 73 i just want a name to my illness. i cant work anymore because the pain killers make me drousy and its impossible to function normally but i need to take them because of the pain so im really struggling for money because cant get esa because my illness dont have a name. can i have a blood test for fm ?

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Jolly72 said on 06 February 2013

Hi ,I just find this group today,I am absolutely fed up to the teeth what I am feeling right .I cannot stop crying I feel I'd rather be dead than living with this pain every day and still smiling while you feel dying inside and get on with with working full time and looking after you little child with no help or no one to be able to talk to at all.People seems to judge you and they pretend they understand you but they don't.I feel at the moment that I'm always so ill that i only have couple of days being well.I am so not coping at the moment I don't know if I can carry on. Is there any help at all financially so that i can cut m,y working hours ? And be able to rest a little bit ? I feel that so many people is not aware of this illness that they think we are just bluffing when we don't feel well at all.I wish i don't have to get up in the morning and have to endure more pain.

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Yummymum45 said on 24 January 2013

I've just joined after yet getting another booking form from my GP to try yet another pain clinic. It's true the comment Jenwen has put about smiling on the outside but being in so much pain on the inside. I'm that bad now I can't sit at the computer and chat to my friends so I've got an iPad which I can take anywhere and can use with one finger if I need to. My pain is that bad after over twenty years of fb that I can't hold the mouse never mind sit at the desk. Walking is very limited to crutches slowly in the house as I lose the use of my legs regularly and my poor fiancé who has given up his job to be my fully time carer has to push me in my wheelchair outside, that's when I go out as pain is that bad now if someone bumps into me I'm in agony for days. I limit going anywhere until its either late on in the day or very early. Even the local hospital where I live didn't have the decency to help me when I went for an infusion as the pain in my neck, back and arms is that bad I need help dressing etc.
I'm now about to try a new hospital recommended by my GP who is fantastic so fingers crossed. I hope they can help with my pain as its now unbearable and I'm on fentanyl patches and oxycodone liquid plus other muscle relaxants and nothing is touching the pain any longer. I'm keeping my fingers crossed well that's if I could lol that there might yet be something else I can try.

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Queen2 said on 28 December 2012

Hi There.... I wrote a response to Fibromyalgia on one fo the other NHS Fibromyalgia comments page about my constant daily struggles with all the factors of Fibromyalgia and at that point I didn't actually know if I had the condition...but after 7 long years the doctor told me today that I have condition...Obviously I wasn't pleased that I have this dreadful condition, as it has so many different symptons....a General feeling of not being with it, aches and pains in my arms feet and knees, upper back pains and chest pains, puffy fingers which go numb and go buzzy and tingle...a feeling like you cant coordnate....panic attacks. diverticulitus, waking up in the middle of the night in severe pain across my upper back and chest, the whole way I have been feeling for so long was and still is driving me mad as you do not feel right, but after being tested for so many things with neuro doctors, rheumatologists, you name it, blood tests for everything over several years, they came ot the conclusion that I have Fibromyalgia.. In real terms I have gone to hell and back again, I think every doctor who I saw thought I was slowly going mental, but on the same token they knew that there was something not right with me because of all the symptons I was and am experiencing Al I can say to anyone here is NEVER give up hope, even when you have been told you have Fibromyalgia, at least knowing what it is does calm you down, but the sensations never seem to go away even with the pills they offer you.

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Meg Warah said on 28 October 2012

I have fibromyalgia. I have ben theough a lot of tests and types of treatment including unnecessary surgery. I am sharing my symptoms and treatments in case useful to you.

Symptoms
Joint and muscle pain, and stiffness particularly in back, knees, wrists.
Bladder disfunction - urinary retention resulting in infections, pain and discomfortfort.
Depression and anxiety
Osteopenia (low bone density with some deterioration in wrists ans spine)
Fatique (second.worst symptom after pain)
Lack of restorative sleep
I
Treatment
Mirtazapine (modern drug instead of amyltriptaline - helps with sleep and pain with fewer side effects)
Venlafaxine (pain coverage in.day time plus helps.with depression)
Oxybutynin patch - for bladder
cefradine - prophylactic antibiotic to prevent bladder infection
calcium and d3
Avoid caffiene and alcohol
Paracetamol or cocodomol to top up pain coverage
Twice daily physio stretches and strength exercises
Rest (probably most important - be realistic about how much u can do. I also use wheelchairs at airports or queue jump to avoid standing for long periods)
I have had a lot of therapy - most centred around managing anxiety and coming to terms with disability.

Note that I still have pain and other symptoms if I do too.much. I have tried a lot of different drugs to find the right combination. So keep at it if u havent found the right combination.

Good luck.

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acheynancy said on 31 March 2012

its nearly 20 years since i was diagnoised with fb. i had to go through years of going to gp for differant painkillers, when i got to the point of dispare my gp sent me to hospital for tests. i had lumber punctures, mri scans and blood tests to eliminate other causes for my symptoms. i was finally diagnoised iwth fb. i have had numerous pain killers over the years and depression meds, to help. but i am now on low dose of slow releasing morpine as well as codeine phospate. it does help but when i get bad flare ups nothing seems to help. i have had other unsympathetic gps in our practice telling me fb does not exist and its in my mind. all i say to these synics is swap me for 48 hours then you will see its in my head. i have also had procaine infusionds in the past which helped, but the consultant that i was under retired and his predeesesor would not prescribe them as they are not used for fb patients.i am pleased i have a good husband and family that help me. i also have found it hard to get disability benifits, as i am unable to work as i can not stand or sit for long periods of time i was a hairdresser and holding brushes combs and dryers is painful.
to anyone who has been newly diagnoised with this condition, there is help out there and you are not alone and you dont have to suffer in silence.

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User660430 said on 27 March 2012

Hello all, just this minute joined. I cannot tell you how relieved I am to finally be able to put a name to what's wrong with me. I;ve had the stabbing burning pains in my neck for nearly 8years, Dr told me it was RSI, I would have it until I die & there was a 1yr waiting list for physio. Have had pain in my groin for 2yrs & as I used to run just thought it was that. But what really made me think I have FB is that I have tinitus which came on almost overnight 1yr ago & I've always had trouble picking things up with the tips of my fingers. I have about 80% of the reported symptoms & seeing my dr this Thursday to try & persuade hime to give me a pain killer that actually kills the pain. I always knew I had something wrong with me,screaming with a toothache, crying over the slightest wound & all that knw me just thought I was a hypochondriac, I even earned the nickname 'sick note' in one office. I'll now stop waffling, all your posts have been most useful to me & it will be great to hear from others like me. Sorry to go on, one part of me that seems to always work fine, my ability to talk....xxxx

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Grace Twinkletoes said on 26 March 2012

I have had this infusion recently in the West Midlands and it's given me a huge break from the pain. I'm still weak and get fatigued very easily, but the relief from the relentless pain is so immense that I can't stop smiling!

It took me 10 years to find a GP who listened to me, the number of times I previously begged to be tested for MS,ME,lupus,fibromyalgia & all the other things I couldn't even begin comprehend. But no, each of my visits were treated as 'run down', 'tired all the time' or 'post viral' - basically regarding each episode as 'merely a result of your hectic lifestyle'.
I continued following the advice of eating healthily and exercising regularly while being a working Mum&single parent...and successfully worked myself into the ground.
Not the desired result,eh?
I collapsed at work 2 years ago and have been imprisoned in a limited existence ever since. It's like only being a fraction of myself & all the comments from you guys on this site are soooo true - just because I'm smiling and I look the same as I did (ok, a few stones heavier now), it doesn't mean I'm not containing an awful lot of pain,stiffness,tired beyond reasonable, and nothing to show for it! I have finally been diagnosed with fibromyalgia.
Who can adequately convey the meaning or feeling of fatigue??
It's not just 'being knackered'!!
Mental fatigue …It's a massive effort to string a sentence together at times, so having to keep going & push extra hard to make it through a working day is nigh-on impossible.

My employer has been really good, changing my work days so I can work&rest alternate days, but it's still a real struggle. Yet I'm greatful for still having a job and knowing I'm lucky to be employed. I just wish it didn't crucify me! I hate having time off but I can't help it. Some colleagues cannot disguise their contempt
And now I feel unemployable, how can I find a job?

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juliaxx said on 21 February 2012

your so right jenwen. i agree in what you say... im sick of being told its all in my head pffttt ..yes of course it is.?. Debilitating is not the word . i need a good doctor to listen to me not fob me off with more pills im on codine 30mg .. seen my doctor 2 days ago after i've put up with so much burning stinging pain in my back and neck to which is affecting my breathing to be told to take 8 a day of codine instead of the 4 a day i was on. i've heard there's an infusion drug that can be used does anyone no about this treatment. or anything that really works . ????? ..

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TiredChris said on 07 February 2012

I have Horrible Myalgic Encephalomyelitis / 'Chronic Fatigue Syndrome,and have had for over a quarter of a century,since Oct 17th 1986. For 24 Years of my ( wasted life the GP's that I saw WEREN'T INTERESTED IN ANALYSING / CURING ME ! ) ( AND People wonder Why I get Upset ! ! More Money needs to be spent on NHS Research. I wish people would dedicate their lives to contacting the Politicans of this Country and remind them that it is one of the the Best uses of taxpayers money ! !
I Have had to report 4 lots of healthcare 'professionals' to the NHS Ombudsmai in London for dereliction of duty ! ! Drat.......

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faithisabella said on 23 September 2011

i was diagnosed with fibromyalgia a number of years ago i was already taking amitriptyline after having varicose veins removed in my leg which wasnt successful as the op left the nerve endings damaged but wasnt told this was the treatment for fibromyalgia i was already on painkillers at this time. recently i was diagnosed with arthrosis now its hard to see where one complaint starts and the other ends i had been suffering severe pain for two and a half years and was being treated for trapped nerves in my neck and head and practically had to demand an x ray which also resulted in having ct scans and blood tests it turns out that the ligaments in my neck are hardening up like bone in my neck i am now waiting to attend physio and i'm taking painkillers for constant pain day and night no one realises how bad the pain is and the sleep deprivation drains your body.

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elsiemae said on 17 June 2011

some doctors dont have a clue, they think its all in your head it just makes you want to cry sometimes

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foxy07 said on 04 June 2011

I was diagnosed with FB last year and took a radical approach to dealing with it. Having being told that the only thing that i could do was to have physio and massage, i was less than happy considering i was very active a year before. I was not prepared to stand still and listen or read to all the negative comments on FB.

I found a nutritional therapist that specialised in adrenal and thyroid function which can often be associated with FB. A GP would not have considered that i had adrenal fatigue but having being tested through nutritional tests, they were severely low although the tests that the GP would have used would not have considered them to be low enough.

Additionally, i looked at food intolerances with the same specialist and my improved health and well being is quite remarked. I started with chronic fatigue, severe food intolerances, leg pain, sleep deprevation, memory loss, intolerance to stress amongst others. Now a year later many of my symptoms have disappeared or certainly are in check and can now exercise more and feel like i really have my life back. I still have leg pain as certain things trigger it and i still have not got to the bottom of all those triggers. Takes time and patience and really listening to your body as to what works and what doesnt is a must. I still have little tolerance for stressful situations which enhance my symptoms but will be focusing now on relaxation techniques, ensuring i exercise regularly. Exercising every day is still impossible as the pain is quite unreal if i do.
I hope this helps, without the support that i received from a reputable qualified nutritional therapist, i would have possibly been in a situation whereby work would have been too difficult to manage and that i was never going to allow.

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new2fibro said on 24 May 2011

I am new to this condition and am finding it very hard to understand, let alone trying to make my family and friends understand. I'm sure that a lot of people think I am just a moaner & a hypochondriac. It has been suggested I do research on Fibromyalgia but a lot of the feedback is quite depressing and negative ,thus leading me to believe my outlook is bleak . Although I am having plenty of support from my GP and my husband, dealing with the complexities and symptoms of this debilitating illness leaves one feeling very much alone & confused. I really need to understand this illness in order to be able to manage it successfully. Normally I am a very positive person but I find myself floundering trying to deal with this. All I can say to people is please do not judge us if you do not know what we are having to cope with day in day out 24/7!

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jenwen said on 22 May 2011

Just because we look well and smile it doesn't mean we are on the inside we are screaming with pain and other symptoms there are over 63 things it promotes in our bodies that we have too cope with.If I am out walking one day that is because it was a good day.

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Support groups

Fibromyalgia can be a difficult condition to live with, and you may find it helps to talk to someone about it.

FibroAction is a charity that offers information and support to anyone who has fibromyalgia.

FibroAction has a telephone service (0844 443 5422) that you can call with any questions about fibromyalgia, and a network of local FibroAction support groups you may find helpful.

There is also a FibroAction online community where you can find out about news, events and ongoing research.