Fibromyalgia
Fibromyalgia: Symptoms, Diagnosis and Support
Fibromyalgia is a long-term condition associated with widespread pain and tenderness, often alongside fatigue, disrupted sleep, cognitive difficulties and increased sensitivity.13
The experience varies considerably between people. Fibromyalgia is real and can significantly affect daily life, but it is not explained by one single cause, brain region or psychological factor.
Understanding the full symptom pattern can help people seek appropriate assessment and build a personalised approach to care.
re-origin is designed to complement not replace appropriate medical assessment and treatment.
Check in with your symptoms
Take the Fibromyalgia Self-Assessment
This short self-assessment can help you reflect on the frequency and impact of symptoms commonly reported with fibromyalgia.
Symptoms such as widespread pain, fatigue, unrefreshing sleep and cognitive difficulties can also have other causes. This assessment cannot diagnose fibromyalgia or determine the cause of your symptoms.
Only a qualified healthcare professional can diagnose fibromyalgia.
Understanding fibromyalgia
What is fibromyalgia?
Fibromyalgia is a chronic condition characterised by widespread pain and tenderness. Commonly reported symptoms also include fatigue, unrefreshing sleep, cognitive difficulties and increased sensitivity to physical or sensory input. Symptoms and their impact vary considerably, and not everyone experiences all of them.123
Symptoms can range from mild to significantly disabling and may fluctuate over time. A person may experience fibromyalgia on its own or alongside another health condition.
Fibromyalgia is not an inflammatory arthritis and does not normally cause progressive joint damage. It can, however, occur alongside arthritis, autoimmune disease, migraine, irritable bowel syndrome, sleep disorders and other health conditions. New, swollen or visibly inflamed joints should still be assessed medically rather than attributed to fibromyalgia.12
The symptoms are real
Fibromyalgia is a recognised and potentially disabling condition. Symptoms are real and are not imaginary or deliberately produced. Pain is a genuine experience involving communication between the body, spinal cord, brain and wider nervous system, and the absence of one confirmatory test does not make symptoms psychological.
What can fibromyalgia feel like?
Fibromyalgia can affect more than pain. Some people also experience headaches, digestive symptoms or mood difficulties. The combination, severity and daily impact of symptoms differ between people.123
Widespread pain and tenderness
Pain may be aching, burning, throbbing, sharp or difficult to describe. It can affect several areas of the body and may change in intensity or location. Read more about chronic pain .
Fatigue and reduced stamina
Fatigue may feel physical, cognitive or both. Rest does not always leave someone feeling restored. Read more about chronic fatigue .
Unrefreshing or disrupted sleep
People may have difficulty falling asleep, staying asleep or waking feeling restored, even after spending enough time in bed. Read more about sleep difficulties .
Cognitive difficulties
‘Fibro fog’ may involve problems with concentration, memory, word finding, organisation or processing information. Read more about cognitive difficulties .
Heightened sensitivity
Some people experience increased sensitivity to touch, pressure, movement, temperature, light, sound, smell or other sensory input. Read more about sensory hypersensitivity and headaches and migraines .
Emotional and everyday impact
Persistent symptoms can affect mood, relationships, confidence, work, movement, social activity and the ability to plan.
Fibromyalgia does not have one single cause
Fibromyalgia is a complex and heterogeneous condition. Research suggests that biological, neurological, genetic, psychological, social and environmental factors may interact, but no single explanation accounts for every person’s experience.178
Pain and sensory processing
Research has identified differences in how some people with fibromyalgia process pain and sensory signals. These findings do not provide one universal biomarker or explain every person’s experience.
Genetics and individual susceptibility
Fibromyalgia can occur within families, suggesting that genetic and individual biological differences may influence susceptibility.
Sleep and physiological stress
Poor sleep, pain, fatigue and stress physiology may reinforce one another. Their relative importance differs between people.
Health events and wider context
Some people report that symptoms began or became more noticeable after an illness, injury, operation or a period of prolonged stress. Many people cannot identify any clear starting point, and a reported event before onset is not the same as a proven cause.
These factors are not personal failings, and they do not mean that one intervention will be appropriate for everyone.
Pain and sensory processing
Central sensitization: when the system becomes more responsive
Central sensitisation describes increased responsiveness within pain-processing systems. It is one important proposed mechanism in fibromyalgia, but it does not explain every symptom or every person’s experience.678
A volume-control metaphor can make the concept easier to understand: the signals entering the system matter, but the sensitivity of the system receiving and interpreting those signals can also affect the final experience.
Fibromyalgia is often discussed in relation to sensitization and nociplastic pain. These concepts may help explain increased pain and sensitivity, but they should not be presented as a complete explanation for every person.678
Sensory or pain-related input
Increased responsiveness in pain-processing systems
Signals may be amplified or prioritised
The final experience may feel more intense
Central sensitisation does not mean that symptoms are imagined, deliberately created or under conscious control.
Why can symptoms fluctuate?
Many people describe periods when symptoms become more noticeable, often referred to as flares. The pattern differs between people, and the influence of individual factors is not always clear.
People report different possible influences on symptom fluctuations, including sleep disruption, illness, changes in activity, emotional stress, hormonal changes and sensory load. These are possible influences, not proven causes or universal triggers.
Poor or disrupted sleep
A possible trigger is not necessarily the underlying cause. New, severe, rapidly worsening or unexplained symptoms should not automatically be assumed to be a fibromyalgia flare.
Getting the full picture
How is fibromyalgia diagnosed?
Fibromyalgia is diagnosed through clinical assessment. There is currently no single laboratory test, imaging scan or biomarker that confirms fibromyalgia.124
A healthcare professional may ask about the location and duration of pain, fatigue, sleep, cognitive symptoms, other health conditions, medication and the effect symptoms have on daily life.
Tests may be used to investigate another possible explanation or a condition that could coexist with fibromyalgia. A person does not have to be free of every other diagnosis before fibromyalgia can be recognised.4
The 2016 diagnostic criteria
The 2016 criteria use the Widespread Pain Index and Symptom Severity Scale. They consider the distribution of pain, the severity of fatigue, unrefreshing sleep, cognitive symptoms and other physical symptoms.4
- Widespread Pain Index of 7 or more with a Symptom Severity score of 5 or more; or
- Widespread Pain Index of 4–6 with a Symptom Severity score of 9 or more
- Generalised pain in at least four of five body regions
- Symptoms present at a similar level for at least three months
- Diagnosis may be made alongside another clinically important condition
Clinical criteria help guide assessment but do not replace professional judgement. The self-report version of diagnostic criteria is not, by itself, valid for diagnosing an individual.4
Discuss symptoms and their impact
Review health history and medication
Consider the distribution and duration of pain
Assess sleep, fatigue and cognitive symptoms
Investigate other relevant medical possibilities
Online information cannot provide a diagnosis
A self-assessment can help organise symptoms, but it cannot determine whether someone has fibromyalgia, identify the cause or establish the safest treatment.
Seek medical advice for new or concerning symptoms
Medical assessment may be particularly important for new weakness or numbness, swollen or visibly inflamed joints, unexplained fever, unexplained weight loss, chest pain, severe or rapidly worsening symptoms, or new neurological changes.
This is not a complete list, and symptoms that are not listed here may still need assessment. Seek urgent or emergency help according to the services available where you live if symptoms suggest an immediate medical emergency.
Treatment and support should be personalised
There is no single fibromyalgia treatment that works for everyone. Treatment plans differ according to symptoms, other health conditions, preferences, daily responsibilities, individual capacity and previous treatment experience.1259
Education and symptom understanding
Clear, non-blaming information can help people understand symptoms, communicate with healthcare professionals and make informed decisions.
Individually appropriate movement
Movement may be introduced in a way that reflects the person’s capacity, health, symptoms and response. The appropriate type, amount and progression differ between people, and movement is not something to push through during a significant worsening of symptoms.
Sleep support
Identifying and treating sleep problems may reduce one contributor to pain, fatigue and cognitive difficulty.
Support for coping and daily functioning
Cognitive behavioural therapy, counselling or other psychological support may help with distress, pain-related fear, avoidance, relationships and the impact symptoms have on daily life. This does not mean that fibromyalgia is psychological.
Medication and specialist care
Medication may be considered for pain, sleep or associated symptoms. The most appropriate option depends on the person, other conditions, possible side effects and guidance in their country.
Do not start, stop, reduce or change medication based on this page. Medication decisions should be discussed with the prescribing clinician or healthcare team.
Neuroplasticity and the nervous system
Where does neuroplasticity fit?
Neuroplasticity and the nervous system
Neuroplasticity is the nervous system’s capacity to change its structure, function and connections through experience and learning.11
Learning and experience can influence attention, expectations, coping, movement, confidence and responses to sensation. For some people living with persistent symptoms, neuroplasticity-informed education may form one part of broader support for symptom-related fear, hypervigilance, avoidance and reduced confidence.
This does not mean that fibromyalgia was caused by thoughts, that symptoms are voluntary or that someone can simply rewire the condition away.
What the research shows
Pain neuroscience education has been studied in people with fibromyalgia. A systematic review found low-quality evidence of short-term reductions in pain intensity and small follow-up changes in fibromyalgia impact, with substantial variation between studies. This research does not establish re-origin or brain retraining as a treatment for fibromyalgia.10
Complementary support—not a fibromyalgia treatment
Pain education and brain-body practices may form part of a wider support plan. The available research should not be used to claim that re-origin treats fibromyalgia or that neuroplasticity practices replace condition-specific healthcare.
Individual experiences and outcomes vary.
Spoon Theory and energy management
This video explores Spoon Theory as one way of communicating limited energy and planning everyday activity while living with fibromyalgia or another chronic condition.
Spoon Theory is a personal energy-management metaphor, not a medical treatment or diagnostic model.
The re-origin approach
Supporting regulation, confidence and everyday practice
re-origin is a neuroplasticity platform for nervous-system health. We bring together science-informed education, brain-body practices, somatic regulation tools, coaching and community support.
For people living with fibromyalgia, re-origin is designed to provide complementary education and practical support around stress responses, symptom-related fear, body awareness, confidence, consistency and participation in everyday life.
Understand interacting patterns
Explore how symptoms, attention, stress responses, thoughts, emotions, habits, behaviour and environment may influence one another.
Work through the brain and body
Combine neuroplasticity education with body awareness and somatic regulation practices.
Build gradual consistency
Use small, repeatable practices that can be adapted to individual capacity and medical needs.
Learn with support
Access coaching options and a community of people who understand complex chronic symptoms.
Science-informed neuroplasticity programs, practices, coaching, and community for nervous system regulation. Built by people who’ve lived it. Designed to meet you where you are. Carried by community.
re-origin does not diagnose or medically treat fibromyalgia and is not presented as a medical treatment. It is not a replacement for medical care, physiotherapy, psychological therapy, medication, sleep treatment or other condition-specific support, and no individual outcome can be predicted.
Member story
Julie’s story: living with fibromyalgia, fatigue and chronic pain
Julie shares her personal experience of fibromyalgia, severe fatigue and chronic pain, and how re-origin, coaching and community support became part of her wider journey.
This story reflects one person’s experience. Results vary, and a testimonial cannot establish that re-origin treats a health condition or predict another person’s outcome.
Questions you may want to discuss with your healthcare professional
01Could another condition be contributing to these symptoms?
02Do my symptoms fit recognised fibromyalgia criteria?
03Could a sleep disorder be affecting pain and fatigue?
04Are any medicines contributing to my symptoms?
05What kind of movement or rehabilitation is suitable for me?
06Which symptoms should prompt further investigation?
These questions are provided to support a clinical conversation, not to direct diagnosis or treatment.
Continue exploring fibromyalgia, pain and nervous-system health
Continue exploring fibromyalgia, pain and nervous-system health
Questions
Fibromyalgia questions and answers
What are the main symptoms of fibromyalgia?
Is fibromyalgia an autoimmune disease?
Fibromyalgia is not generally classified as an autoimmune disease. It can, however, occur alongside autoimmune conditions, and research into its biology continues.
A healthcare professional can assess whether symptoms may relate to fibromyalgia, an autoimmune condition or another explanation.
Is fibromyalgia a neurological condition?
How is fibromyalgia diagnosed?
Can fibromyalgia coexist with another condition?
Yes. Fibromyalgia may occur alongside arthritis, autoimmune disease, migraine, irritable bowel syndrome, sleep disorders or other health conditions. Another diagnosis does not automatically exclude fibromyalgia.4
What is a fibromyalgia flare?
A flare is a period when symptoms become more noticeable or disabling. Sleep disruption, illness, changes in activity, emotional stress, hormonal changes and sensory load are possible influences rather than proven causes, and they differ between people.
Can fibromyalgia improve?
Fibromyalgia symptoms and their impact can change over time. Some people experience periods of lower symptom burden, while others continue to have significant or fluctuating difficulties.
Treatment and support generally focus on reducing symptoms, improving function and addressing factors such as sleep, movement and emotional wellbeing. No individual outcome can be predicted from this page.
Is fibromyalgia all in the brain?
No. Fibromyalgia is a complex condition involving pain and sensory processing alongside symptoms such as fatigue, sleep disruption and cognitive difficulty.
The brain and wider nervous system are involved in every experience of pain, but this does not mean symptoms are imaginary, voluntary or caused by a person’s thoughts.
What is central sensitization?
Can neuroplasticity help with fibromyalgia?
Neuroplasticity is a normal property of the nervous system. Education and brain-body practices may help some people work with factors such as symptom-related fear, attention, coping, movement confidence and stress responses.
These approaches are complementary. They have not been established as a cure for fibromyalgia and do not replace appropriate medical assessment or condition-specific treatment.1011
Is re-origin a treatment for fibromyalgia?
No. re-origin provides science-informed education, neuroplasticity practices, coaching options and community support. It does not diagnose or medically treat fibromyalgia.
Should I stop medication while trying re-origin?
No. Do not stop, reduce or change medication without guidance from the prescribing clinician.
Living with fibromyalgia can be challenging
Appropriate healthcare, practical support and gradual brain-body practices may each have a place.
Explore how re-origin brings together science-informed education, nervous-system practices, coaching and community support.
Medical disclaimer
The information on this page is provided for educational purposes only. It is not intended to diagnose, treat, cure or prevent any condition and does not replace assessment, diagnosis or treatment from qualified healthcare professionals. Do not start, stop or change medication or treatment based on this page. Seek appropriate medical advice for new, severe, worsening or unexplained symptoms.
References
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. Fibromyalgia: Overview, Symptoms and Causes. Read the NIAMS fibromyalgia overview View source
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. Fibromyalgia: Diagnosis, Treatment and Steps to Take. Read the NIAMS diagnosis and treatment guidance View source
- Centers for Disease Control and Prevention. Fibromyalgia. Read the CDC fibromyalgia page View source
- Wolfe F, Clauw DJ, Fitzcharles MA, et al. 2016 Revisions to the 2010/2011 Fibromyalgia Diagnostic Criteria. Seminars in Arthritis and Rheumatism. 2016;46(3):319–329. doi:10.1016/j.semarthrit.2016.08.012. PMID: 27916278. View the 2016 criteria on PubMed View source
- Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR Revised Recommendations for the Management of Fibromyalgia. Annals of the Rheumatic Diseases. 2017;76(2):318–328. doi:10.1136/annrheumdis-2016-209724. PMID: 27377815. Read the EULAR recommendations View source
- Clauw DJ. Fibromyalgia: A Clinical Review. JAMA. 2014;311(15):1547–1555. View the JAMA clinical review on PubMed View source
- Sarzi-Puttini P, Giorgi V, Marotto D, Atzeni F. Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment. Nature Reviews Rheumatology. 2020;16:645–660. View on PubMed View source
- Iannuccelli C, Favretti M, Bianchi B, et al. Pathogenetic and clinical aspects of fibromyalgia: one year in review 2026. Clinical and Experimental Rheumatology. 2026;44(6):1057–1068. doi:10.55563/clinexprheumatol/asx3uo. PMID: 42328952. View the DOI record View source
- Bazzichi L, Di Carlo M, Salaffi F, et al. Therapeutic advances in fibromyalgia: one year in review 2026. Clinical and Experimental Rheumatology. 2026;44(6):1069–1081. doi:10.55563/clinexprheumatol/xscnij. PMID: 42328945. View the DOI record View source
- Suso-Martí L, Cuenca-Martínez F, Alba-Quesada P, et al. Effectiveness of Pain Neuroscience Education in Patients With Fibromyalgia: A Systematic Review and Meta-analysis. Pain Medicine. 2022;23(11):1837–1850. doi:10.1093/pm/pnac077. PMID: 35587171. View on PubMed View source
- Cramer SC, Sur M, Dobkin BH, et al. Harnessing Neuroplasticity for Clinical Applications. Brain. 2011;134(6):1591–1609. doi:10.1093/brain/awr039. View the DOI record View source