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The Beyond Pain Foundation

Conditions we support

Conditions guide

Fibromyalgia

Fibromyalgia causes pain all over the body, along with deep tiredness, poor sleep and problems with memory and concentration. It is real, it is common, and it can be managed. This guide explains the symptoms, how it is diagnosed, the treatments available in the UK, and your rights at work.

People affected to some degree
Nearly 1 in 20
It usually starts between ages
25 and 55
Who it affects more
Women more than men
Symptoms usually present for
3 months or more before diagnosis

This guide is general information, not medical advice. Medicines and treatments must be prescribed or recommended for you by a doctor or pharmacist. We do not give doses here.

What fibromyalgia is

Fibromyalgia is a long-term condition that causes pain across the body. The pain is real. It happens because the nervous system processes pain signals differently, so the body becomes much more sensitive to pain. It does not damage your joints or muscles.

Nobody knows exactly what causes it. It may run in families. It often starts after a physical or emotional strain, such as an injury, an infection, an operation or a very stressful time. Sometimes there is no clear trigger.

The NHS says nearly 1 in 20 people may be affected to some degree. It is more common in women, and it usually starts between the ages of 25 and 55, but it can affect anyone, including children and older people.

Doctors now group fibromyalgia under chronic primary pain. This is pain that lasts more than 3 months and is not fully explained by another condition. Read our chronic widespread pain guide for more on this.

How it can show up

There aren't official types of fibromyalgia, but it affects people in different ways. You may recognise more than one of these.

Widespread pain

The main symptom. Pain in many areas, often the neck and back. It can ache, burn or stab, and it is often there most of the time.

Extra sensitivity

Things hurt more than they should. Even light touch, pressure or tight clothing can be painful.

Fatigue-led

For some people, exhaustion and poor sleep are the hardest part. Sleep often doesn't feel refreshing.

Fibro fog

Trouble remembering, learning new things and concentrating. It can make work tasks and conversations harder.

With other conditions

Fibromyalgia often comes with irritable bowel syndrome, headaches or migraine, anxiety or depression. It can also happen alongside arthritis or lupus.

Mild to severe

Some people manage work and family life with small changes. Others are badly limited. How it affects you can change over time.

Symptoms and flares

As well as pain, tiredness, poor sleep and fibro fog, you may have stiffness (often worst in the morning), headaches, dizziness, clumsiness, feeling too hot or cold, restless legs, pins and needles, and painful periods.

Symptoms go up and down. A flare is a time when symptoms get much worse. Flares can be set off by stress, changes in the weather, poor sleep, illness, or doing more (or less) than usual.

  1. Day to day

    Baseline

    Your usual level of symptoms. Knowing your baseline helps you plan and spot changes.

  2. Hours to a day or two

    Early warning

    More aches, worse sleep, more tiredness or fog. A good time to ease off and rest more.

  3. Days to weeks

    Flare

    Pain, tiredness and fog are much worse. Normal tasks may be very hard.

  4. Days to weeks

    Settling

    Symptoms ease back towards your baseline. Build back up slowly to avoid another flare.

These timings vary a lot from person to person. They are a rough guide, not a rule.

Watch out for boom and bust

On a good day it is tempting to catch up on everything. This often leads to a crash for days afterwards. Spreading tasks out evenly, even on good days, usually means fewer and shorter flares. This is called pacing.

When to get urgent help

Fibromyalgia doesn't cause serious damage to your body. But new or different symptoms should never just be put down to fibromyalgia.

Call 999 or go to A&E if you have

  • chest pain, or pain spreading to your arm, jaw or back
  • sudden weakness or numbness on one side, or trouble speaking
  • sudden, very bad breathlessness
  • loss of bladder or bowel control with back pain
  • thoughts of ending your life and feel you may act on them

Call NHS 111 if

  • you have a new, severe pain that is not like your usual pain
  • you have a high temperature with severe pain
  • you are in a mental health crisis. In England, call 111 and choose the mental health option (option 2)
  • you need help and your GP is closed

See your GP if

  • you think you may have fibromyalgia
  • you have swollen joints, a rash, weight loss or fevers
  • your symptoms are getting worse or changing
  • you feel low or anxious most days

Living with pain can be very hard. If you are struggling, you can talk to Samaritans any time, day or night, free on 116 123.

Diagnosis and referral

There is no single test for fibromyalgia. Your GP can diagnose it. UK guidelines from 2022 say a GP or physiotherapist is well placed to make the diagnosis, without needing a specialist.

Your doctor will ask about your pain, where it is, how long you have had it and how it affects your life. Symptoms usually need to have been present at a similar level for at least 3 months. They will examine you and usually arrange blood tests to rule out other causes, such as thyroid problems, anaemia or inflammation.

Your GP may refer you to a rheumatologist (a joint and muscle specialist) if the diagnosis isn't clear or there are signs of another condition. They may refer you to a pain clinic if treatment isn't helping.

Treatments and medicines

No single treatment works for every symptom. Most people do best with a mix of activity, talking therapy and, for some, medicine. NICE's chronic pain guideline (NG193) sets out what the NHS should offer.

Exercise programmes

GP, physiotherapist or local NHS service

NICE recommends a supervised group exercise programme. No one type of exercise is best. Start very gently and build up slowly. It may take some weeks before you notice a difference.

Talking therapies

NHS Talking Therapies (self-referral in England) or GP

Acceptance and commitment therapy (ACT) and cognitive behavioural therapy (CBT) can help with pain, sleep and how you cope. They do not mean the pain is "in your head". They work by changing how pain affects your life, and the benefits build over a course of sessions.

Antidepressants

Prescription, for adults 18 and over

NICE says doctors can consider amitriptyline, citalopram, duloxetine, fluoxetine, paroxetine or sertraline. These can help pain, sleep and distress even if you are not depressed. They often take a few weeks to help, and should be reviewed with your doctor.

Acupuncture

Sometimes on the NHS, often private

NICE says a single short course can be considered. The NHS notes the benefit has only been shown to last up to 3 months.

Painkillers NICE says not to start

For chronic primary pain such as fibromyalgia, NICE advises doctors not to start paracetamol, anti-inflammatories such as ibuprofen, opioids such as codeine or tramadol, gabapentin or pregabalin, or benzodiazepines. There is little evidence they help this kind of pain, and some can cause harm or dependence over time.

If you already take one of these and it helps, NICE says your doctor should review it with you, not just stop it. Don't stop any medicine suddenly without advice.

NICE also advises against TENS machines, ultrasound and interferential therapy for chronic primary pain, as the evidence does not show they help.

Specialist options

  1. Rheumatology

    If the diagnosis is unclear

    A rheumatologist can confirm fibromyalgia and check for other conditions, such as inflammatory arthritis or lupus.

  2. Pain clinic

    If first treatments haven't helped

    NHS pain clinics have doctors, nurses, physiotherapists and psychologists. They can review your medicines and offer support to manage pain day to day. Your GP needs to refer you.

  3. Pain management programme

    Usually group sessions over several weeks

    These courses aim to improve your quality of life rather than remove the pain. They cover pacing, gentle exercise, relaxation, sleep and coping with emotions. NICE did not find enough evidence to recommend them for chronic primary pain, but many NHS pain services still offer them.

Self-help and living well

Day to day

  • Pace yourself: break tasks into smaller chunks with rests between
  • Keep gently active, even on bad days, at a level that suits you
  • Try warm water: a bath, shower or hydrotherapy pool
  • Plan your week so busy days are followed by quieter ones

Sleep and mind

  • Keep regular times for going to bed and getting up
  • Cut down caffeine and screens in the evening
  • Try relaxation, breathing or mindfulness
  • Join a support group so you don't feel alone

Learning how pain works can also help. Flippin' Pain explains the science of pain in plain language.

Getting the best care

Before and during appointments

  • Keep a simple diary for a few weeks: pain, sleep, energy, fog and what you did that day
  • Write down your top 3 questions before you go
  • Explain what you can't do any more, not just how much it hurts
  • Ask: "Could this be fibromyalgia, and what else have you ruled out?"
  • Ask about NHS exercise programmes, Talking Therapies and pain clinic referral
  • Bring someone with you to take notes if fog makes it hard to remember
  • Ask for a double appointment if you have a lot to cover

If you don't feel listened to, you can see another GP at your practice, or ask for a referral for a second opinion. You don't have to prove your pain is real. It is.

Fibromyalgia and work

Fibromyalgia can count as a disability under the Equality Act 2010 (the Disability Discrimination Act in Northern Ireland). This applies if it has more than a minor effect on your daily life and has lasted, or is likely to last, at least 12 months. Conditions that come and go can count.

If so, your employer must make reasonable adjustments. These might include:

  • Flexible start and finish times
  • Working from home some or all of the time
  • Regular short breaks to move or rest
  • A phased return after time off
  • Written instructions and reminders to help with fog
  • Parking close to the entrance
  • Time off for appointments
  • Changes to duties during a flare

Ergonomic equipment can make a big difference. Examples include an adjustable ergonomic chair, a sit-stand desk, a supportive cushion, a monitor arm, a lightweight laptop, an ergonomic keyboard and mouse, and voice recognition software to cut down on typing.

Access to Work is a government grant that can pay for equipment, support workers and travel to work. For advice on your rights, contact Acas or Citizens Advice.

Benefits

If you can't work because of your symptoms, you may get Statutory Sick Pay from your employer for up to 28 weeks. You may also be able to get Personal Independence Payment (PIP), or Adult Disability Payment in Scotland, whether or not you work. Depending on your situation, Universal Credit or Employment and Support Allowance may help. Fibromyalgia Action UK runs a benefits helpline, and Turn2us and Citizens Advice can help you check.

How The Beyond Pain Foundation can help

If NHS waits are too long, or the help you need isn't available to you on the NHS, we may be able to fund:

  • A private consultation with a rheumatologist or pain specialist
  • Physiotherapy or hydrotherapy to help you build up activity safely
  • A course of acupuncture, as NICE suggests can be considered
  • A pain management programme or course
  • Workplace or home equipment, such as an ergonomic chair, sit-stand desk or supportive seating

We fund treatment and equipment, not everyday living costs such as rent or bills. Treatment must be from a registered or qualified practitioner. Prices vary, so always get a written quote to include with your application.

Apply for funding Check the requirements

Support and sources

Fibromyalgia Action UK

Charity, helpline and local groups

Helpline 0300 999 3333, Monday to Friday, 10am to 4pm. Benefits helpline 0300 999 0055. Free booklets and support groups.

fmauk.org

Flippin' Pain

Pain education

Plain-language videos, podcasts and worksheets on how persistent pain works and what helps.

flippinpain.co.uk
Sources for this guide

Last reviewed: October 2026.