What is fibromyalgia?
Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, sleep issues, and cognitive difficulties ("fibro fog"). Affects about 2% of US adults; far more common in women.
Modern understanding: fibromyalgia is a disorder of pain processing — the central nervous system amplifies pain signals. It's real, treatable, and shouldn't be dismissed as imaginary.
Do I have fibromyalgia? Common signs
If most of these describe what you're experiencing, telehealth may be a good next step:
What causes it
Unknown — likely central nervous system pain amplification. Strong family component. Often triggered by infection, trauma, surgery, or significant stress. Coexists frequently with depression, anxiety, IBS, migraines.
Is it contagious?
No.
Treating fibromyalgia isn't about masking pain — it's about resetting how the brain processes signals. That requires both medication and movement.
Can it be treated online?
Fibromyalgia is well-suited to telehealth follow-up. Initial diagnosis benefits from in-person evaluation to rule out other conditions (rheumatologic, thyroid, hypovitaminosis). Severe refractory cases may benefit from rheumatology or pain management referral.
How fibromyalgia is treated
FDA-approved for fibromyalgia: duloxetine (Cymbalta), milnacipran (Savella), pregabalin (Lyrica). Amitriptyline at low dose (10–25mg at bedtime) is helpful for sleep and pain. Gabapentin sometimes used. Aerobic exercise (gentle, gradual) has strong evidence. Cognitive behavioral therapy (CBT) reduces symptoms.
Self-care while you wait
- Gentle aerobic exercise — walking, swimming, water aerobics
- Strength training as tolerated
- Pacing — don't push through, then crash
- Sleep hygiene is critical
- Stress management — yoga, meditation
- Address coexisting anxiety/depression
- Avoid trigger foods if you have patterns
- Heat therapy for muscle pain
- Heat or cool compresses
How long does it last?
Chronic but manageable. Most patients see meaningful improvement with comprehensive treatment.
Frequently asked questions
Is fibromyalgia real?
Yes — there's measurable evidence of central pain processing differences. The medical community fully recognizes it as a real condition.
Will medication cure it?
Medication reduces symptoms but doesn't cure. Combined with exercise, sleep, and stress management, most patients achieve significant function.
Why does exercise help when it hurts?
Counterintuitive but well-evidenced. Start very gently and build slowly. Pacing matters — don't overdo on good days.
Are there blood tests for it?
No definitive lab test. Diagnosis is clinical (widespread pain >3 months with other features). Labs rule out other causes.
Does diet help?
Some patients identify food triggers. No universal 'fibro diet' but Mediterranean-style eating supports overall health.
