Fibromyalgia is a chronic condition that causes pain throughout the body, as well as fatigue. Research suggests that fibromyalgia happens when the body's central and peripheral nervous systems don't process pain properly.
While it's often grouped with rheumatic diseases, it's not considered to be a disease of inflammation, or a joint or muscle disorder. And it's also not an autoimmune disorder, in which the body's immune system mistakenly attacks healthy tissues.
Everyone who has fibromyalgia experiences it differently, which is one reason why misunderstandings and myths often surround this condition. Even healthcare professionals may be misinformed about it.
Knowing the facts about fibromyalgia — and being able to separate them from myths — is essential to making the best choices to control the condition.
"The more informed and active the patient is, the better off they are in conditions like this," says Don L. Goldenberg, MD, a rheumatologist and professor emeritus of medicine at Tufts University School of Medicine in Boston. "They really need to get solid medical information."
In that spirit, here are 10 widely held misconceptions about fibromyalgia, as well as what we know to be true.
Myth 1: It Isn't a Real Disorder
Fact: Fibromyalgia was officially recognized as a disease by the World Health Organization in 1994.
The condition causes "chronic, widespread muscle pain," he notes. "By the time people see doctors, it's usually many months or years" since symptoms began.
But many doctors, Goldenberg laments, still don't understand the condition.
"Most doctors think that if your elbow hurts, or your knee hurts, or your shoulder hurts, the pathology is directly in those areas," he says. "In fibromyalgia, that doesn't work. The pain is actually coming from the brain."
This misunderstanding of the origins of the pain, says Goldenberg, is "one of the reasons it's very controversial, and was for a long time kind of pooh-poohed as, 'it's all in your head.'"
Myth 2: Fibromyalgia Is a 'Catchall' Diagnosis
Fact: Fibromyalgia has specific diagnostic criteria, developed and updated by the American College of Rheumatology (ACR).
Many people are under the impression that fibromyalgia is a "catchall" or "fallback" diagnosis because there isn't any single test or obvious symptom used to diagnose it.
"There's very little to see on a physical exam," Goldenberg says. "Laboratory tests to look for causes of pain are unremarkable."
According to the ACR, fibromyalgia is diagnosed based on the following factors:
Multiple painful areas of the body (on both sides, above and below the waist)
Additional symptoms, like fatigue, poor sleep, and difficulty thinking or concentrating
Symptoms that last for at least three months
No other apparent cause of these symptoms
Myth 3: Fibromyalgia Only Affects Women
Fact: Between 75 and 90 percent of people diagnosed with the disorder are women, according to the National Fibromyalgia Association (NFA).
Fibromyalgia affects an estimated 10 million adults in the United States, the NFA says, which means that between 1 million and 2.5 million men in the United States have been diagnosed with fibromyalgia.
But Goldenberg says that the actual incidence among men may be even higher, since gender-based bias may play a role in how doctors diagnose fibromyalgia.
Fibromyalgia can also occur in children and teens.
Myth 4: Fibromyalgia and Arthritis Are the Same Condition
Fact: Fibromyalgia and arthritis have little in common, other than sensations of pain and fatigue.
Unlike arthritis, fibromyalgia "doesn't primarily affect joints. It affects muscles and soft tissue," says Goldenberg.
And unlike arthritis and other rheumatic (arthritis-like) disorders, fibromyalgia isn't a disease characterized by inflammation. In fact, markers of inflammation tend to be normal.
Instead of the pain coming from an inflamed area of the body, in fibromyalgia, "The pain is actually coming from the brain, from the central nervous system," says Goldenberg.
Myth 5: A Special Fibromyalgia Diet Is Needed
Fact: There's no specific diet recommended for people with fibromyalgia, but certain foods can worsen symptoms while others may improve them.
Researchers have found that dietary fiber from fruits, whole grains, vegetables, and other plant products may ease fibromyalgia symptoms by altering the gut microbiota and that supplementing with probiotics may improve cognitive function. Evidence also suggests that an anti-inflammatory and gluten-free diet may have beneficial effects.
Focus on following a healthy, balanced diet that includes whole grains, lean protein sources, low-fat dairy products, fruits and vegetables, and plenty of water.
It's also a good idea to limit your consumption of caffeine, refined sugars, fried foods, red meat, processed foods, and alcohol.
Myth 6: Complementary Treatments Are Pointless
Fact: Meditative movement therapies — such as tai chi, yoga, and qigong — appear to improve fibromyalgia symptoms, according to research.
Acupuncture has also been found to reduce pain and improve quality of life.
And connective tissue massage was found to help with pain, fatigue, and sleep disruption in women with fibromyalgia.
Myth 7: You Should Avoid Exercise
Fact: Exercise is the single most effective treatment for fibromyalgia, according to the American College of Rheumatology.
Aerobic exercise, in particular, has been shown to be helpful in reducing fibromyalgia symptoms. This includes activities like walking, biking, swimming, and water aerobics.
Goldenberg believes that stretching and strength training are also helpful for many people. Strength training can mean using weights, exercise machines, exercise bands, or your own body weight for resistance.
While exercise may be painful or difficult at first if you have fibromyalgia, regular physical activity can help improve your symptoms and make exercising easier.
Myth 8: You're Just Tired
Fact: Fatigue in fibromyalgia goes far beyond just being tired. As Goldenberg notes, the condition causes "a tremendous amount of fatigue. People are very exhausted."
While fatigue is a common symptom of fibromyalgia, research has found that it doesn't occur in isolation.
Instead, fatigue in fibromyalgia is interwoven with other symptoms — including pain, sleep disruption, and mood disturbances — and all of these symptoms can influence one another.
Myth 9: You Can Take a Pill to Make Fibromyalgia Symptoms Disappear
Fact: Drug treatments don't work very well for many people with fibromyalgia.
"The truth is, we don't have very good medications," says Goldenberg. "They work well in maybe one out of three or four patients."
While you may see some benefit from taking a drug approved to treat fibromyalgia, your symptoms will probably just diminish, not disappear.
You'll probably also still need to incorporate lifestyle measures, like exercise, stress reduction, good sleep habits, and possibly cognitive behavioral therapy (CBT), into your treatment plan.
Myth 10: There's Nothing You Can Do
Fact: While there's no cure for fibromyalgia — and medication doesn't work for everyone — there's still a wide range of options available for treatment.
"Nonpharmacological approaches actually work as well, or maybe even better," than drugs for many people with fibromyalgia, Goldenberg notes.
If your current treatment isn't giving you the relief you need, work with your doctor to try something new, whether it's exercise, prescription drugs, over-the-counter (OTC) pain relievers, or alternative treatments, like massage or meditative movement.
The Takeaway
Misconceptions about fibromyalgia persist, despite specific diagnostic criteria and the fact that it affects approximately 10 million adults in the United States.
Talk with your healthcare providers to explore both medical and lifestyle interventions, as medication alone might not fully relieve symptoms.
While there is no cure for fibromyalgia, treatments such as aerobic exercise, stretching, strength training, and complementary therapies like tai chi and acupuncture can help manage symptoms.
Diet plays a supportive role in managing fibromyalgia. A balanced diet rich in whole grains, lean proteins, fruits, and vegetables, and with few refined sugars or processed foods, may alleviate symptoms for some.
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Metyas C et al. Diet and Lifestyle Modifications for Fibromyalgia. Current Rheumatology Reviews. April 16, 2024.
Prabhakar A et al. The Role of Complementary and Alternative Medicine Treatments in Fibromyalgia: a Comprehensive Review. Current Rheumatology Reports. March 4, 2019.
Toprak Celenay, S et al. A Comparison of the Effects of Exercises plus Connective Tissue Massage to Exercises Alone in Women with Fibromyalgia Syndrome: A Randomized Controlled Trial. Rheumatology International. August 24, 2017.
Couto N et al. Effect of Different Types of Exercise in Adult Subjects with Fibromyalgia: A Systematic Review and Meta-Analysis of Randomised Clinical Trials. Scientific Reports. June 20, 2022.
Vincent A et al. Beyond Pain in Fibromyalgia: Insights into the Symptom of Fatigue. Arthritis Research & Therapy. November 29, 2013.
Al Sharie S et al. Unraveling the Complex Web of Fibromyalgia: A Narrative Review. Medicina. February 4, 2024.
Beth Biggee, MD, is medical director and an integrative rheumatologist at Rheumission, a virtual integrative rheumatology practice for people residing in California and Pennsylvania. This first-of-its-kind company offers whole person autoimmune care by a team of integrative rheumatologists, lifestyle medicine practitioners, autoimmune dietitians, psychologists, and care coordinators.
Dr. Biggee also works as a healthcare wellness consultant for Synergy Wellness Center in Hudson, Massachusetts. Teamed with Synergy, she provides in-person lifestyle medicine and holistic consults, and contributes to employee workplace wellness programs. She has over 20 years of experience in rheumatology and holds board certifications in rheumatology and integrative and lifestyle medicine. Dr. Biggee brings a human-centered approach to wellness rather than focusing solely on diseases.
Dr. Biggee graduated cum laude with a bachelor's degree from Canisius College, and graduated magna cum laude and as valedictorian from SUNY Health Science Center at Syracuse Medical School. She completed her internship and residency in internal medicine at Yale New Haven Hospital, completed her fellowship in rheumatology at Tufts–New England Medical Center, and completed training in integrative rheumatology at the University of Arizona Andrew Weil Center for Integrative Medicine. Following her training, she attained board certification in rheumatology and internal medicine through the American Board of Internal Medicine, attained board certification in integrative medicine through the American Board of Physician Specialties, and attained accreditation as a certified lifestyle medicine physician through the American College of Lifestyle Medicine. She is certified in Helms auricular acupuncture and is currently completing coursework for the Aloha Ayurveda integrative medicine course for physicians.
In prior roles, Dr. Biggee taught as an assistant clinical professor of medicine at Mary Imogene Bassett Hospital (an affiliate of Columbia University). She was also clinical associate of medicine at Tufts University School of Medicine and instructed "introduction to clinical medicine" for medical students at Tufts. She was preceptor for the Lawrence General Hospital Family Medicine Residency.
Dr. Biggee has published in Annals of Rheumatic Diseases, Arthritis in Rheumatism, Current Opinions in Rheumatology, Journal for Musculoskeletal Medicine, Medicine and Health Rhode Island, and Field Guide to Internal Medicine.
A freelance health writer and editor based in Wisconsin, Quinn Phillips has a degree in government from Harvard University. He writes on a variety of topics, but is especially interested in the intersection of health and public policy. Phillips has written for various publications and websites, such as Diabetes Self-Management, Practical Diabetology, and Gluten-Free Living, among others.
