Written by: THE BALANCE
Medically reviewed by Dr. Sarah Boss, MD
Last updated: January 19, 2026
Fact checked
Quick Summary
  • Fatigue and pain can so overwhelm patients that they usually find it difficult to focus on their daily routine activities (commonly referred to as "fibro fog").
  • The pain is chronic and anxiety, depression, and social isolation can be a result.
  • Sleep disorders, irritable bowel syndrome (IBS), and heightened sensitivity to stimuli such as light, noise, or temperature may also be present.
Reading time: 15 min

Fibromyalgia is often a life-altering disease. Fatigue and pain can so overwhelm patients that they usually find it difficult to focus on their daily routine activities (commonly referred to as “fibro fog”). The condition affects not only physical health but also mental health. The pain is chronic and anxiety, depression, and social isolation can be a result. Sleep disorders, irritable bowel syndrome (IBS), and heightened sensitivity to stimuli such as light, noise, or temperature may also be present.

As confirmed by the National Fibromyalgia Association, Fibromyalgia affects about 10 million people in the U.S. The treatment plans must be customized and multi-faceted to improve a patient’s quality of life.

Traditional medicine can help relieve fibromyalgia symptoms with medications. These treatments cannot cure the condition but can help to reduce the pain, improve sleep, and deal with any associated mental health problems.

Prescription Medications

Fibromyalgia is treated with several classes of drugs, which are determined by a patient’s individual symptoms and health history.

Antidepressants: The two medications most commonly prescribed to fibromyalgia patients are amitriptyline and duloxetine. These drugs regulate levels of neurotransmitters in the brain and help control both pain and depression [1]. A study published in Pain Medicine showed that low doses of amitriptyline improve sleep quality and decrease pain in people with fibromyalgia, a chronic muscle pain condition.

Anticonvulsants: Newly approved drugs to treat fibromyalgia include pregabalin and gabapentin, which were developed for their use as anti-epileptic drugs. They work by decreasing activity in the nerves that are overactive and act to aggravate pain. In the past, the first FDA-approved drug for fibromyalgia, pregabalin, has shown efficacy in reducing pain intensity and improving function [1].

Pain Relievers: Sometimes, acetaminophen and prescription drugs such as tramadol and codeine are used. But typical nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids as a rule don’t work for fibromyalgia pain and aren’t recommended because of risks of addiction or different reactions.

Fibromyalgia Medicines Approved By FDA

Three medications have been FDA-approved specifically for fibromyalgia treatment; these medications include pregabalin, duloxetine, and milnacipran [2]. 

Depending on how the disorder presents, there are different medications available to target aspects like pain control to mood stabilization. Of all of them, however, milnacipran, a serotonin-norepinephrine reuptake inhibitor, (SNRI) has demonstrated efficacy in improving physical function in fibromyalgia patients [3].

Guidelines For Medication Treatment Of Fibromyalgia

Fibromyalgia expertise advises a careful approach to medicine for fibromyalgia. The American College of Rheumatology (ACR) recommends that, when possible, nonpharmacologic interventions should be initial treatment with the use of medications reserved for as needed. 

Drugs are often prescribed, but it’s important to watch the results to see if they are working and to change the dose or change drugs if they are not. The aim is to find a balance between good symptom control and the smallest possible side effects.

Although medications can be used to treat the symptoms of fibromyalgia, non-pharmaceutical therapies are important. In addition to relieving pain, these therapies can improve physical function psychological function, and the person’s quality of life.

Cognitive Behavioral Therapy

One of the most well-researched psychological treatments for fibromyalgia is Cognitive Behavioral Therapy (CBT). It is concerned with changing negative patterns of thought that make pain and disability worse. According to a study published in The Journal of Rheumatology, patients who participated in CBT sessions saw great improvements in pain, fatigue, and depression. 

While CBT does not treat fibromyalgia or eliminate its symptoms, it can teach people coping strategies, such as stress management and relaxation techniques, that will help to lessen the severity of the symptoms. Fibromyalgia is a chronic condition, and of course, that means a huge mental toll; CBT also helps provide a patient more control over their pain [4].

Physical Therapy And Exercise

Exercise is frequently recommended as part of the fibromyalgia treatment and prevention strategies. Even though exercise may be initially daunting because of all the pain and fatigue that comes along with the condition, physical activity can ultimately improve upon itself over time. 

Physical therapy meets each patient where they are at capacity, then focuses on stretching, strengthening, and aerobic exercises.

Yoga, swimming, and tai chi have proved their worth in the battle against fibromyalgia. For example, according to a study in Arthritis Research & Therapy, yoga might improve mobility, and relieve symptoms and mood in people with fibromyalgia. 

Another highly recommended low-impact exercise is swimming since the buoyancy of the water then reduces the stress on joints and muscles yet it gives you cardiovascular benefits.

Adaptation Of Lifestyle Through Occupational Therapy

Fibromyalgia occupational therapy enables fibromyalgia patients to change their daily activity to lessen pain and fatigue. Individuals are taught by therapists to change their environment, develop routines that conserve energy, and use appropriate ergonomics. 

Things as simple as using adaptive tools or learning new ways of performing household tasks can greatly improve function and reduce flare-ups.

Fibromyalgia patients often seek complementary and alternative medicine (CAM) therapies as adjunctive therapy, over and above conventional treatment. Despite ongoing research on the use of many CAM therapies, some people report benefits from them.

Acupuncture: How It Helps Fibromyalgia Pain

Acupuncture is a Chinese traditional medicine practice that uses thin needles to be inserted into specific points of the body. The efficacy of this therapy is thought to rely upon the stimulation of the body’s natural painkillers and increased blood flow, which alleviates fibromyalgia pain [1]. 

A review published in Pain Medicine reported that acupuncture can create a modest amount of pain relief and improve sleep and fatigue in fibromyalgia patients. The evidence is at best mixed, but many patients do get relief, so there’s good reason to consider this as a non-pharmacologically based treatment.

Massage Therapy: Relaxes The Muscles And Eases Fatigue

Another CAM option that’s often sought out to lessen muscle aches, stiffness, and fatigue of fibromyalgia is massage therapy. The most commonly used techniques are myofascial release and deep tissue massage which focus on trigger points in muscles [3]. 

According to a study published in The Journal of Clinical Rheumatology, regular massage sessions reduced the pain intensity, as well as the quality of life, of fibromyalgia patients.

Supplements Commonly Used For Fibromyalgia Relief

A lot of patients go to supplements to try and relieve fibromyalgia symptoms. Some commonly used supplements include:

Magnesium: Muscle cramps and pain are often signs of a magnesium deficiency. Magnesium supplementation appears to improve muscle function and reduce pain in fibromyalgia sufferers according to some studies [1].

Vitamin D: Many fibromyalgia patients are deficient in vitamin D and research has also shown that their levels of vitamin D may be related to increased pain sensitivity. A study from the Journal of Pain found that correcting vitamin D deficiencies has reduced pain in some patients.

Melatonin: Due to commonly reported sleep disturbances in fibromyalgia, melatonin supplements are used to help balance sleep quality. Supplementation with Melatonin can promote deeper, more restful sleep that is regulated by Melatonin, a hormone that regulates sleep-wake cycles [3].

Natural Fibromyalgia Treatments: Safety And Efficacy

CAM therapies can provide relief, but they should always be discussed with a patient’s healthcare provider before being started. Some supplements and alternative therapies have not been well studied and may have a risk of interacting with your prescription medication. If so, then that said, combining conventional and alternative treatments to form a holistic approach provides the best option for fibromyalgia management.

The cornerstone of fibromyalgia treatment includes lifestyle changes, sometimes even more important than treatment with medications and therapies. They are encouraged to adjust their diet, sleep, and daily routines to combat their symptoms. Such modifications give overall wellbeing and if cautiously used will prevent flare-ups and are vital in the management of fibromyalgia.

Essential Dietary Changes

The aim of the Anti-Inflammatory Diet and its impact on both the chronic condition IBS (irritable bowel syndrome) and the systemic chronic inflammation, revealed by a blood biomarker, C-Reactive Protein (CRP) is to understand.

The level of inflammation, energy, and even pain in fibromyalgia patients is largely dependent on their dietary choices. Eating an anti-inflammatory diet rich in fruits, vegetables, whole grains, lean proteins, and healthy (especially omega-3 fatty acid) fats has been shown to alleviate pain and result in decreased fatigue. Also, foods high in anti-oxidants like berries, green leafy vegetables, and nuts can help reduce oxidative stress, also thought to be one of the causes of fibromyalgia [4].

According to numerous studies, the Mediterranean diet amongst other dietary approaches can help improve fibromyalgia symptoms. Instead, this diet emphasizes plant-based foods, lean proteins (such as fish and chicken), and healthy fats, improving both cardiovascular and metabolic health, both of which are commonly found to be dysfunctional in fibromyalgia patients.

But some foods may make symptoms worse. Foods that are processed, refined sugars, along with excessive amounts of caffeine can cause inflammation and pain sensitivity. In many patients, keeping a food diary may help to identify specific foods that trigger symptoms.

How Important Is Sleep Hygiene

The majority of fibromyalgia patients experience sleep disturbances and will mention difficulty falling asleep, staying asleep, or achieving restorative sleep. Lack of sleep can make pain, fatigue, as well as fibro fog (cognitive issues), worse. That’s why good sleep hygiene is so important in the management of fibromyalgia symptoms.

To improve sleep quality, fibromyalgia patients are advised to:

  • Try to get to bed and wake up at the same time each day.
  • Make small changes such as having a calming bedtime routine, for example, reading or a relaxation routine.
  • Check that the bedroom is dark, quiet, and at a cool temperature so it is comfortable and conducive to rest.
  • Avoid drinking caffeine or alcohol — especially in the afternoon or evening — both of which can disrupt sleep patterns.

By improving sleep, many patients report lower pain levels and more energy, which is vitally important to fibromyalgia treatment and prevention.

The physical side of fibromyalgia is, by no means an isolated disorder and is closely intertwined with the psychological component. Patients commonly suffer from stress, anxiety, and depression all of which can exacerbate symptoms. For that reason, the mental and emotional aspects of fibromyalgia need to be addressed as part of a holistic treatment.

Stress Management Techniques Have A Role

Fibromyalgia symptoms are aggravated by stress, and treatment involves managing stress. Deep breathing exercises, progressive muscle relaxation, and guided imagery are techniques that help patients calm their nervous system, and decrease pain. By learning how to properly manage your stress you can prevent over-activating the pain pathways typically triggered by fibromyalgia.

Moreover, regular practice of these techniques reduces the body’s production of stress hormones, such as cortisol, which is increased in fibromyalgia sufferers and which may further contribute to their symptoms.

Mindfulness And Meditation

Increasingly, fibromyalgia patients are being recommended mindfulness-based therapies, such as mindfulness meditation. These practices allow people to recognize their body and their feelings and not be overtaken by pain. Fibromyalgia patients who practice mindfulness meditation may experience less pain, less emotional distress, and a greater overall quality of life, a study published in The Journal of Pain finds.

In turn, mindfulness helps people accept that they have a condition without beating themselves up about it and empowers them while reducing the mental load of chronic pain. There are other ways regular practice can help, too: with sleep and concentration, two other areas often affected by fibromyalgia.

Biofeedback And The Reduction Of Stress

Biofeedback is a method of allowing your patients to have control over involuntary physiological functions (heart rate and muscle tension). Patients can learn to moderate their responses to pain and stress by using sensors to measure bodily functions. Fibromyalgia treatment with biofeedback has shown promise to help patients lower their stress levels and thus manage their symptoms better.

Counseling For Emotional Relief And Support Groups

When you have fibromyalgia, you may feel isolated and many of the patients find support from joining groups or getting individual counseling. Talking with others who know what it feels like to live with fibromyalgia can be both emotionally relieving and help with practical ways to cope. There are support groups, both in person and online, where you can talk about fears, frustrations, and successes with managing the condition.

Counseling is also useful especially if the pace is done with a therapist that has experience with chronic illness. Therapy often uses cognitive—behavioral techniques to help replace negative thoughts and behaviors that may make fibromyalgia symptoms worse. 

In a study published in Rheumatology International, counseling was found to help improve a fibromyalgia patient’s ability to manage pain and quality of life, especially if other treatments were added.

While fibromyalgia research evolves, some promising new treatments are emerging, helping to control the complex symptoms of fibromyalgia. These therapies are in the experimental or early clinical trial phase, but they are starting as promising paths to better pain management, improved function, and potentially fewer flare-ups down the road.

Neuromodulation Techniques

Neuromodulation is the process of changing nerve activity by the application of electrical or pharmacological agents to a target area of the brain, spinal cord, or peripheral nerves. Neuromodulation for fibromyalgia is based on the idea that abnormal or wrong pain signals that the central nervous system sends to the body are causing pain, so by modulating those abnormal pain signals, the pain should be alleviated.

Transcranial Magnetic Stimulation (TMS): The magnetic fields used by TMS have been studied as a potential treatment for fibromyalgia. According to a 2015 review in Current Rheumatology Reports, TMS could cut down between one-half and all of a fibromyalgia patient’s pain, particularly if those areas are targeted that are associated with pain processing. TMS is generally a noninvasive procedure performed as an outpatient procedure, which serves as an appealing alternative therapy to medication for many patients.

Vagus Nerve Stimulation (VNS): It seems to be involved in the control of stress responses and inflammation. In VNS a small device placed in the chest sends electrical impulses to the vagus nerve. By calming the hyperactive nervous system this technique may ease pain and fatigue in fibromyalgia patients, according to studies. Yet, as a potentially new approach to the neural mechanisms of the complex fibromyalgia symptoms, VNS is still experimental.

Electrical Nerve Stimulation

Noninvasive methods, also referred to as peripheral nerve stimulation (PNS) and Transcutaneous Electrical Nerve Stimulation (TENS) utilize electrical impulses to hinder pain. Especially, TENS is widely available and can be used at home. TENS does this by stimulating the nerves with low-voltage electrical currents, which may lower the amount in which the brain perceives the pain. A study in Pain found that fibromyalgia patients using TENS regularly had less pain intensity and greater physical function.

Fibromyalgia Therapy In Regenerative Medicine

Fibromyalgia is at the forefront of exciting research in regenerative medicine, medicine designed to repair or replace damaged tissues. Although fibromyalgia is not typically considered a disease where damage caused by tissue results in chronic pain, researchers are investigating how regenerative techniques may help repair nerve or muscle tissues that might be contributing to fibro pain.

So far, studies have shown that stem cells have a special ability: the ability to develop into different cell types and eventually repair damaged tissues. Stem cell therapy as a treatment for fibromyalgia is still in its infant stage, but some researchers think it will help modulate the immune system and relieve inflammation, which you assume to be part of the fibromyalgia symptoms. 

A pilot study published in the journal Clinical and Translational Medicine looked at whether mesenchymal stem cells might help with fibromyalgia, finding that patients’ pain and fatigue may decrease after treatment with the cells, though further study is needed.

FAQs

Is Fibromyalgia Treatable?
There is no cure for fibromyalgia, but fibromyalgia can be treated. At this time, there isn’t a definitive cure for fibromyalgia, but there are many treatments that can help manage its symptoms and improve quality of life. Treatment consists of an assortment of methods like prescription medications, physical therapy, cognitive behavioral therapy (CBT), and beneficial changes in eating, exercise, and stress management.
How Does Pacing Improve Fibromyalgia Symptoms?
For fibromyalgia patients, pacing is commonly recommended as a means of maintaining effective personal energy levels and avoiding symptom flares. It’s about planning daily activities so that activities and periods of rest are balanced and you don’t exhaust yourself to prevent flare-ups. For instance, they may segment tasks, doing them in small steps; alternate between mental and physical tasks; and schedule breaks recovering every hour or hour and a half, instead of a longer break once a day. 
The aim is to save energy and avoid the revered ‘boom and bust’ pattern wherein patients do too much on good days and react with a big ramp of pain and fatigue thereafter. 
Does Fibromyalgia Treatments Differ In Men vs. Women?
Fibromyalgia is more commonly diagnosed in women, but men can have the condition. Fibromyalgia is often underdiagnosed or misdiagnosed in men, perhaps because they don’t report pain and fatigue the same way as women or because their healthcare providers may not recognize the condition as readily in a male patient. Once diagnosed, however, there are usually similar treatment strategies for men and women. In any case, some treatments or medications might be a different response for men, as they have hormonal and physiological differences. That is why personalized treatment plans cannot be based on gender, but instead personalized to individual symptoms.

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