Fibromyalgia is a long-lasting disorder that causes pain and tenderness all over the body. It also brings tiredness and trouble sleeping.1 The most useful thing to understand is how it works. People with fibromyalgia are more sensitive to pain. They feel pain when others do not.1 The problem is in how the body handles pain signals. It is not a damaged joint waiting to show up on a scan. That is why normal test results are the rule. They are not a sign that nothing is wrong.
What causes fibromyalgia pain?
The cause is not known. But brain scans and other research point to a change in the nerve pathways that send and receive pain. In fibromyalgia, those signals are altered.1 The same changes may also add to the tiredness, sleep problems and thinking problems.1
This changes how to read your test results. If the pain signal is being turned up in the pain-signaling pathways, a clear X-ray is exactly what you would expect. It is not evidence against your symptoms.
What does fibromyalgia pain feel like?
The main symptom is long-lasting pain all over the body or in many areas. It often hits the arms, legs, head, chest, abdomen, back and buttocks. People describe it as aching, burning or throbbing. Tiredness and trouble sleeping come with it.1
Other symptoms may include stiff muscles and joints and tenderness to touch. Some people get numbness or tingling in the arms and legs. Many have trouble with focus, clear thinking and memory, sometimes called “fibro fog”. Light, noise, odors and temperature can feel too strong. Gut problems such as bloating or constipation are common too.1
Why the list is so long
Pain plus sensitivity to light, noise, odor and temperature fits one picture. The nervous system is turning up the volume on everything it senses. These are not a string of unrelated complaints. Shown one at a time to different doctors, each symptom gets its own referral. Shown together, they form a clear pattern.
Who gets fibromyalgia?
Anyone can get fibromyalgia, but more women than men have it. It can start at any age, even in children. It usually starts in middle age, and the odds rise with age. It shows up in people of every racial and ethnic background.1
People with other diseases may be more likely to have fibromyalgia. This is true most of all for rheumatic diseases (joint and immune diseases like arthritis), mood disorders, or other painful conditions.1 That overlap is a reason to check, not to assume one diagnosis rules out another.
How is fibromyalgia treated?
Treatment usually combines three parts: exercise or other movement therapy, talk and behavior therapy, and medicine.1 No single part carries the load. The behavior part is not an add-on. It is one of the three named parts.
At this practice, we do that behavior work in-house. We do not send you elsewhere. Counseling for chronic pain and the relationship between anxiety, PTSD and chronic pain explain how we use it. Sometimes one specific pain source sits on top of the widespread sensitivity. That source is worth finding and treating on its own. The range of pain treatments covers those options. lifestyle medicine handles the metabolic and activity side.
Frequently asked questions
All my tests came back normal. Does that mean nothing is wrong?
No. Fibromyalgia means more sensitivity to pain. The nerve pathways that send and receive pain signal differently. So normal scans are expected. They do not contradict your pain. How scans fit into pain diagnosis is covered in what imaging can and cannot show about pain.
Is fibro fog a real symptom?
Yes. Trouble with focus, clear thinking and memory are known symptoms. Research suggests the same altered pain signals may feed them, along with tiredness and sleep trouble. Testing of thinking skills is described under cognitive assessment.
Can I have fibromyalgia and another pain condition at the same time?
Yes, and it is common. Other diseases make fibromyalgia more likely. This is true most of all for rheumatic diseases, mood disorders or other painful conditions. A specific pain source still deserves its own exam. See the range of pain treatments.
Why is counseling part of the treatment for a physical pain condition?
Because talk and behavior therapy is one of the three named parts of standard care. The other two are movement therapy and medicine. We provide it in-house here. We do not send you out. See counseling for chronic pain.
Does it only affect middle-aged women?
No. More women than men have it, and it usually starts in middle age. But it can start at any age, even in childhood. It shows up in people of every racial and ethnic background. To set up an exam, use the appointment request form.
How do doctors test for fibromyalgia?
Routine tests and scans usually come back normal, and that is expected. The problem is in how the nervous system handles pain. It is not a damaged joint an X-ray can find. What points to fibromyalgia is the pattern. Look for widespread aching, burning or throbbing pain. Add tiredness, poor sleep and trouble focusing. Add sensitivity to light, noise, odors and temperature. Then look at it as one picture, not one complaint at a time.
To have widespread pain checked, request an appointment, call (314) 481-5000, or text (314) 886-5902.
Sources
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. Fibromyalgia: Overview, Symptoms & Causes. National Institutes of Health. Accessed August 12, 2026. NIAMS — Fibromyalgia
Dr. Gurpreet Singh Padda, MD, MBA, MHP
