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Fibromyalgia is a long-term condition of widespread body pain, fatigue and unrefreshing sleep, usually with problems in memory and concentration. Pain can come from things that should not hurt at all, such as a hug or the weight of a blanket.
It is a recognised condition with a physical basis. Canadian guidance states that abnormalities in pain processing have been identified at various levels of the nervous system. Arthritis Society Canada says directly that fibromyalgia has often been perceived as an imaginary disease, and that clinicians now recognise multiple physiological factors at play.
It is not a form of arthritis or an inflammatory disease, and Arthritis Society Canada says it does not cause permanent damage to muscles, bones or joints.
Symptoms persist and fluctuate over time.
Some things cannot be changed:
Others can often be worked on, usually with support from a health care team:
Your family doctor or nurse practitioner can diagnose fibromyalgia. Canadian guidance calls it a positive clinical diagnosis, not a diagnosis of exclusion, needing no specialist confirmation. The assessment looks at the pattern: pain at multiple sites, described as six of nine body regions, with moderate to severe sleep problems or fatigue for three months or longer. Tender point counts are no longer used and guidance calls them clinically irrelevant. No test confirms fibromyalgia, and only simple bloodwork is recommended, to exclude an underactive thyroid, anemia or inflammation.
Canadian guidance keeps most care in primary care and combines approaches. A health care team may discuss:
What combination fits, and at what pace, is a decision for you and your clinician.
There is no confirmatory test, no single cause and no treatment that works for most people. Canadian guidance states that medicines afford only modest relief, and the measures with the strongest support, exercise and stress reduction, are hard to start when pain and fatigue are the problem. The Canadian numbers are dated, the most recent being from the 2014 Canadian Community Health Survey. Research is looking at whether changes in pain processing can be measured, at which non-drug approaches help which people, and at medicines aimed at altered pain signalling.
Studies are how those questions get answered. Taking part is voluntary, informed consent comes first, and you can stop at any time without affecting your regular care. No one can say whether a study will help you personally.
This page is written in plain language for people considering clinical research. It is general health information, not medical advice, and it does not replace a conversation with your own doctor or nurse practitioner.
Yes. The Canadian Pain Society and Canadian Rheumatology Association recommendations state that abnormalities in pain processing have been identified at various levels of the nervous system in fibromyalgia. Arthritis Society Canada addresses the misconception directly, saying fibromyalgia has often been misunderstood and perceived as an imaginary disease, and that clinicians now recognise multiple physiological factors are at play, describing the pain as nociplastic, meaning the nervous system's processing of pain signals is altered. In the 2014 Canadian Community Health Survey, 519,146 people in Canada aged 12 and older reported a diagnosis of fibromyalgia.
Usually not. Canadian guidance states that fibromyalgia is a positive clinical diagnosis, not a diagnosis of exclusion, and that it does not require specialist confirmation. Arthritis Society Canada says family doctors can diagnose it, based on pain at multiple sites across six of nine body regions together with moderate to severe sleep problems or fatigue lasting three months or longer, plus supporting symptoms. Simple blood tests are usually done to exclude conditions such as an underactive thyroid, anemia or an inflammatory condition. Tender point examination is no longer used, and referral is reserved for unusual presentations.
This is a common worry, and it is why pacing matters. The Canadian recommendations describe regular exercise and stress reduction as the cornerstone of fibromyalgia treatment, and Arthritis Society Canada lists regular physical activity first among its management approaches, alongside pacing techniques for fatigue so that activity is spread out rather than crammed into better days. How much, what kind and how quickly to build up are the parts that need individual planning, and that is a conversation for you and your own clinician or a physiotherapist.
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