Doctors are still unsure what causes fibromyalgia, which involves pain but no signs of injury or inflammation. A wide range of natural and medical treatments can help.

This article looks at how to relieve the pain and other symptoms of fibromyalgia using medications, complementary therapies, and self-care strategies, including dietary changes.

Various medicines can help ease the symptoms of fibromyalgia. These include:

Over-the-counter pain medications

Over-the-counter drugs may help manage fibromyalgia pain. Some examples include aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin, Advil) and naproxen (Aleve).

If these are not effective, a doctor may prescribe stronger options.

Fibromyalgia drugs

The Food and Drug Administration (FDA) has approved three drugs specifically for treating fibromyalgia. They include:

  • pregabalin (Lyrica), a gamma-aminobutyric acid agonist and antiepileptic, which may calm overactive nerves
  • duloxetine (Cymbalta), a serotonin-norepinephrine reuptake Inhibitor (SNRI), which increases levels of the brain chemicals serotonin and norepinephrine to dampen pain signals
  • milnacipran (Savella), another SNRI to reduce pain

A 2018 study with 1,421 participants who had fibromyalgia found that using pregabalin led to improvements in pain, quality of life, mood, and sleep. In the study, conducted over 7 years, pregabalin was more effective at pain reduction than opioids.

Researchers believe that SNRI medications, such as duloxetine and milnacipran, reduce pain by balancing the activity of the body’s noradrenergic system. This is the network of nerves responsible for the synthesis, release, and storage of norepinephrine.

People with fibromyalgia may need to try several drugs or different dosages before they find the right combination for them. Let the doctor know about any side effects, and ask how long the medication takes to work. Some drugs take several weeks to become fully effective.

Antidepressants

Research from 2017 suggests that low levels of the chemical serotonin make people more vulnerable to fibromyalgia. Selective serotonin reuptake inhibitors (SSRIs), which increase serotonin levels, may help with some fibromyalgia symptoms.

A 2015 meta-analysis of studies found little evidence that SSRIs worked to ease pain, fatigue, and sleep problems in people with fibromyalgia.

However, the researchers concluded that SSRIs might help relieve depression in people with this condition, which can lead to depression and anxiety. Some people may find that taking antidepressants improves their mood, which helps them manage the pain more effectively.

Some SSRIs that doctors prescribe for people with fibromyalgia include:

  • fluoxetine (Prozac, Sarafem)
  • paroxetine (Brisdelle, Paxil, Pexeva)
  • sertraline (Zoloft)

Sleep medications

Sleeping can be difficult with fibromyalgia pain, and sleep deprivation can make the pain worse.

If strategies such as regularly going to bed at the same time and investing in a more comfortable mattress are not effective, doctors may prescribe sleep medications.

Narcotic pain medication

Narcotic pain relievers called opioids change the way the brain responds to pain. They can relieve many types of pain, although their effectiveness for fibromyalgia is unclear.

The previously mentioned 2018 study found that the fibromyalgia drug pregabalin relieved pain better than opioids in people with fibromyalgia.

Although some people with chronic pain benefit from opioids, both the Centers for Disease Control and Prevention (CDC) and the American College of Rheumatology warn against using opioids for fibromyalgia pain.

Side effects of opiods, such as mood changes, sleep disruption, and trouble with thinking and memory, are also symptoms of fibromyalgia. Opioid use can make these symptoms worse.

And because opioids can be addictive, it is essential to speak with a doctor about the benefits and risks of these drugs before taking them. The doctor may recommend other treatments first.

Non-narcotic pain medication

Research into other fibromyalgia treatments is ongoing. For example, a 2020 study that included 74 people with fibromyalgia found that intravenous lidocaine produced long-lasting pain relief.

The following nondrug approaches may relieve symptoms on their own or improve the effects of conventional treatments.

Talking therapies

Some studies suggest that therapy can help people cope with fibromyalgia. This does not imply that fibromyalgia symptoms are “all in a person’s head.” Instead, it reflects that pain is a psychological and physical experience.

Stress and lack of social support can make a person’s pain less manageable. Therapy can provide an outlet and help a person with fibromyalgia find new ways to cope with decreased mobility, the complexities of the medical system, and any unsympathetic colleagues, employers, or loved ones, for example.

People may prefer online or in-person therapy. A 2015 study found that both ways of having cognitive behavioral therapy (CBT) helped with depression and fibromyalgia symptom-related distress. However, only face-to-face therapy improved daily functioning.

CBT can also teach a person relaxation techniques to help ease the pain. And a 2019 study found that CBT helped relieve insomnia and fibromyalgia pain in people with both conditions.

Exercise

A 2015 review confirmed that obesity can occur with chronic pain. The researchers concluded that weight reduction can be an important part of pain management but noted that specific long-term strategies to achieve this remained unclear.

There is no evidence that any particular exercise program is more effective than another at easing pain. But most forms of exercise seem to lead to at least modest pain relief.

Some exercise options that are supported by research include:

A person with fibromyalgia should choose the approach to exercise that works best for them.

Diet changes

There is some evidence that fibromyalgia may be linked to chronic inflammation. However, some experts believe that it stems from pain signaling, not inflammation.

For some people, an anti-inflammatory diet may help. This involves eating foods such as raspberries, fish, onions, and nuts. Processed foods, salt, and heavy alcohol consumption can increase inflammation, so a person with fibromyalgia may benefit from avoiding these things.

A 2020 study found that women with fibromyalgia had a four times higher risk of metabolic syndrome, which can make fibromyalgia symptoms worse. A low glycemic index diet can help mitigate the effects of metabolic syndrome.

Always speak with a healthcare professional before making any significant dietary changes. A registered dietitian can help a person map out a diet that is balanced, healthy, and satisfying.

A person can find out which foods trigger their symptoms by keeping a food diary and tracking changes in symptoms that may correspond.

In a section below, we describe specific foods that a person with fibromyalgia might want to avoid and others that might be beneficial.

Vitamins and supplements

Some healthcare professionals believe that nutritional deficiencies, such as low levels of vitamin D or magnesium, might cause or worsen fibromyalgia symptoms. In this case, certain vitamins and supplements might help.

However, a 2017 meta-analysis of studies did not find convincing evidence that vitamin or mineral deficiencies contribute to chronic fatigue syndrome and fibromyalgia. It also found no evidence that supplements were effective.

Anyone interested in trying supplements should speak with a doctor first. It is usually possible to test for any deficiencies and then determine whether any supplements are necessary.

Stress management

Emotional stress is a possible trigger for fibromyalgia. Stress management techniques may, therefore, make symptoms less severe.

The key is for each person to find a method that fits their lifestyle. Some people socialize, while others find that new hobbies or other distractions work well.

Here, find five relaxation techniques.

Mindfulness and meditation

Meditation, particularly mindfulness meditation, which encourages increased awareness of the present moment, may help with fibromyalgia symptoms.

A 2014 study found that mindfulness alleviated many fibromyalgia symptoms in women, including stress and sleep problems. Participants who practiced mindfulness reported less severe symptoms and a lower perceived burden associated with fibromyalgia.

A 2017 review of studies found that mindfulness practices focusing on acceptance, nonattachment, nonjudgmental awareness, and social engagement were most effective for people with fibromyalgia.

Meditation may also help reduce stress and anxiety, forms of psychological stress. In some people, psychological stress can be a fibromyalgia trigger.

Complementary therapies

A person might find that any of these complementary therapies help manage their symptoms:

These methods may work for some people and not for others. Research into their effectiveness has arrived at mixed results — some of which have been promising. For example, a 2015 meta-analysis of studies investigating the effects of different types of massage showed that most types improved the quality of life for people with fibromyalgia.

Complementary medicine may offer its best results when it accompanies traditional treatments.

Lifestyle changes

Some self-care strategies can help a person be more comfortable and sleep better, thus improving fibromyalgia symptoms. Tips include include:

  • using a comfortable but ergonomically sound chair, especially when working at a desk
  • having good posture
  • having healthy sleep hygiene, including regularly going to bed at around the same time
  • investing in a comfortable mattress and pillow

Working with a supportive medical team

Finding a sympathetic doctor can be key for an accurate diagnosis and effective, tailored treatment.

Feeling heard and understood is critical for accessing the best combination of treatments. A person with fibromyalgia should work with specialists in chronic pain.

Anyone who feels dismissed or unheard may wish to switch to a new healthcare team.

A person with fibromyalgia may benefit from an anti-inflammatory and low glycemic diet. Below, we look at specific foods that may be beneficial or potentially harmful.

Foods to eat:

  • fruits like strawberries and blueberries
  • leafy green vegetables
  • olive oil
  • tomatoes
  • fatty fish
  • whole grains
  • beans
  • pasta
  • low-fat diary
  • nuts

Foods to avoid:

  • white bread
  • rice cakes
  • crackers
  • bagels
  • cakes
  • pastries
  • fried foods
  • sweetened drinks, such as sodas
  • red meats
  • margarine

Here, find 26 healthy meal ideas for an anti-inflammatory diet.

Fibromyalgia is a lifelong condition, but it is not progressive. This means that it does not get worse steadily over time.

However, many people with this illness have periods when symptoms are less or more severe. When symptoms worsen, this is called a “flare.”

Treating fibromyalgia involves reducing symptoms and preventing flares.

Fibromyalgia is a chronic, nonprogressive medical condition with no known cure. Many people have specific triggers, such as stress or injuries, that aggravate their symptoms. Treatment focuses on easing the symptoms and preventing them from worsening.

Managing fibromyalgia involves finding the right combination of treatments. This might include medications, self-care techniques, and complementary therapies. What works for one person might not work for another, and the best approaches may change with time.

Finding a supportive doctor, reporting any changes in symptoms, and being willing to experiment can help.