It has been almost 15 years since I was diagnosed with fibromyalgia, and managing it is just a normal part of my life now. But I know that’s not true for lots of people, so I’ve done my research to talk about fibromyalgia symptoms, treatment, diagnosis, management, and more. That being said, it’s time to ask and answer some of the most commonly asked questions about fibromyalgia, including whether fibromyalgia is an autoimmune disease. 

I am not a medical professional of any kind! I cite my sources and/but you should talk to your doctor. Additionally, this post contains affiliate links. Thank you for supporting Kate the (Almost) Great™!

Is Fibromyalgia an Autoimmune Disease? What You Should Know

I haven’t written a ton about fibromyalgia over the years, primarily because there’s so much we don’t know. One of the only things we know about it is that it’s a real condition that impacts 2-4% of all people (x). I figured, though, that it was time to dig deep into research to compile an FAQ of sorts.

Because of how little we know now, I would not be surprised in the least if this post is outdated in 5 years. As such, this post is one where I will provide multiple sources for the same information. Because fibro is such a confusing condition, I want to make sure I give you as many resources as possible for understanding it. 

Is Fibromyalgia an Autoimmune Disease?

According to the American College of Rheumatology (ACR), fibromyalgia is not an autoimmune disease (x). It is, however, a common comorbidity of chronic illnesses, especially rheumatic ones like rheumatoid arthritis (x, x). Basically, while it is not an autoimmune disease, it often shows up in people who have them.  

To be completely clear, though, this is something debated a lot among chronic illness patients and even some doctors. I would not be surprised if new research came out saying it actually is an autoimmune disease. Not to say that I know better than medical researchers; I just wouldn’t be surprised. 

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How does a person get fibromyalgia? 

Like many conditions, we aren’t 100% sure, but there are some theories. The Mayo Clinic says, “With fibromyalgia, many researchers think nerves are affected in a way that causes the brain and spinal cord to change. This change involves an irregular rise in levels of certain chemicals in the brain that signal pain. In addition, the brain’s pain receptors seem to develop a sort of memory of the pain. They can start to overreact to painful and nonpainful signals” (x).

People who have fibromyalgia are likely to: 

• Be assigned female at birth 
• Have a mood disorder, rheumatic disease, or other chronic pain
• Have a family history of fibromyalgia 
• Have a history of repeated injury 
• Be between the ages of 30 and 50

(Sources: Mayo Clinic, NIH, CDC)

Fibromyalgia also seems to be triggered by a traumatic event – like a car accident or breaking a bone – or a viral infection (x). 

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How serious is fibromyalgia?

If you or someone you know is having suicidal thoughts, please, call or text 988 to reach the Suicide and Crisis Lifeline.

Like with all illnesses, how serious fibromyalgia can be will depend from person to person. Can fibromyalgia directly cause death? No, as far as we know, it can’t. Can it disable? Yes. 

In addition to the social and medical models of disability, fibromyalgia patients do receive government assistance. Like with all conditions, just receiving a diagnosis is not enough; you need to be so disabled from your fibromyalgia that you cannot work (x). I couldn’t find recent or reliable numbers on how many fibromyalgia patients receive disability assistance in the US. The best numbers I could find were in this study, which showed 35% of patients with fibromyalgia received disability payments, while 42-56% of patients with fibromyalgia and some kind of arthritis received payments. 

A bigger risk for fibromyalgia patients is suicide, as fibromyalgia patients are “particularly prone to suicide, in terms of ideation, attempt, risk and events, warranting a pre-emptive screening of their mental health status” (x). 

A 2014 study evaluated suicidal ideation among people with fibromyalgia compared to those with low back pain or people without any kind of chronic pain. It found that “Total depression scores were highest among patients with fibromyalgia and were significantly different from those of both the controls and of patients with low-back pain” (x).

Furthermore, this study found that, “Suicidal ideation was almost completely absent among the controls, with only two (4%) subjects reporting passive suicidal ideation; was low among patients with low-back pain, with six (18.8%) patients reporting passive suicidal ideation; and was prominent among patients with fibromyalgia, with 18 (41%) patients reporting passive suicidal ideation and six (13.6%) patients reporting active suicidal ideation” (x).  

However, suicide is preventable. This is true in general as well as in fibromyalgia patients. Chronic pain plus the comorbidities of depression and anxiety make fibromyalgia patients susceptible to suicide, but it is still preventable. 

Below, I talk about various ways to treat fibromyalgia. In addition to CBT and ACT – two specific kinds of therapy – many patients benefit from talk therapy. Finding a therapist who specializes in chronic illness can help navigate life with fibromyalgia, and having that support can also reduce depression. The Suicide Prevention Resource Center says, “A key element of suicide prevention is ensuring that individuals with suicide risk have timely access to evidence-based treatments, suicide prevention interventions, and coordinated systems of care” (x). 

Below are hotlines for the English-speaking countries who visit KTAG the most: 

• In the United States, call or text 988 to reach the Suicide and Crisis Lifeline
• In the UK, call 0800 587 0800 to reach Suicide Prevention UK 
• In Australia, call 13 11 14 to reach Lifeline
• In Canada, call 988 for the Suicide Crisis Hotline 

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What are the most severe symptoms of fibromyalgia?

This depends wildly on the person. For some, the pain is the worst, but for others, it’s fibro fog or fatigue. 

Here are common symptoms of fibromyalgia: 

• Chronic pain 
• Fibro fog 
• Fatigue 
• Trouble sleeping
• Headaches
• Tenderness to touch 
• Digestive issues

(Sources: ACR, NIH, CDC)

In my experience, fibromyalgia pain is more generalized than RA pain. The NIH says, “Pain is often felt in the arms, legs, head, chest, abdomen, back, and buttocks. People often describe it as aching, burning, or throbbing” (x). 

Fibro fog is brain fog but specifically when a fibromyalgia patient has it (x). People are a lot more familiar with the concept of brain fog since COVID started, but when I developed and was diagnosed with fibromyalgia back in 2011, I had only heard about fibro fog.

Fatigue is not just being tired; it’s getting 8 hours of sleep and still being tired and not feeling well-rested. As the Cleveland Clinic says, “Extreme fatigue makes it hard to get up in the morning, go to work, do your usual activities and make it through your day. Fatigue feels like you have an overwhelming urge to sleep, but you may not feel refreshed after you rest or sleep” (x). 

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What is fibromyalgia treatment? 

Since it’s unknown exactly how fibromyalgia works, there are a LOT of different treatment options. 

For relieving current pain, doctors recommend over-the-counter pain relievers like Tylenol, Advil, and Aleve (Mayo Clinic, CDC). A 2025 study said that there is ”Moderate quality evidence [showing] that muscle relaxants were associated with a small reduction in pain intensity for patients with fibromyalgia” (x). 

Opioid pain medications are not recommended for fibromyalgia, especially because they don’t really work for fibromyalgia pain (Mayo). I don’t talk about this a lot, but I do have an opioid prescription, and it has never helped my fibromyalgia pain. How do I know this for certain? Well, I have a lot of different conditions causing pain, and when I take my medication, it helps the pain for all those other things, but not the fibromyalgia. That’s not to say that it’s impossible, just that if opioids do help people with fibromyalgia, it’s so infrequent that there isn’t enough evidence to support it. (Not to mention lots of doctors are hesitant to prescribe them for people who have conditions known to benefit from opioids, let alone one that is known to not.)

The medications most prescribed for fibromyalgia are antidepressants and anti-seizure medications (Mayo, Stanford, NHS, Johns Hopkins). These are the real medication treatments and what can improve patient quality of life over time. Think of it like this: Aleve isn’t a treatment for my rheumatoid arthritis, but Rituxan is. Stanford says, “Medication selection is highly individualized, as responses vary significantly between patients” (x). While this can be true for all chronic illnesses, it is especially true for fibromyalgia.  

The best explanation for why these medications are used as fibromyalgia treatment is “Generally medications are used to manage pain, fatigue, and psychological distress, as well as to improve other health issues associated with FM (e.g., migraine headache, irritable bowel syndrome)” (x). The problem is that, since we don’t really know how fibromyalgia works, we can’t treat the root cause of the illness, meaning we have to treat the myriad of different symptoms. Johns Hopkins goes on to say, “A recent review of drug treatments for FM indicates that tricyclic antidepressants (TCA’s), including amitriptyline and doxepin, are effective in treating multiple FM symptoms including pain, sleep disturbance, fatigue, and depression” (x).

Now, let’s talk about the non-medication fibromyalgia treatments. Here is a non-exhaustive list of ways to manage/treat your fibromyalgia. 

• Physical therapy 
• Occupational therapy
• Exercise
• Massage
• Myofascial release therapy
• Aqua therapy
• Accupressure
• Meditation
• Accupuncture
• Yoga 
• Biofeedback 
• Supplements
• Osteopathic or chiropractic manipulation
• Talk therapy
• Acceptance and commitment therapy 
• Cognitive behavior therapy 

Sources: Stanford Medicine, Mayo Clinic, NHS, Johns Hopkins 

If you’re like me and have multiple illnesses, make sure you talk to your different doctors to make sure something that is good for fibromyalgia won’t harm your other conditions. 

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What are common lifestyle changes for fibromyalgia?

I know that this is very similar to the last point, but I wanted to go into more detail on lifestyle changes specifically, not treatments. 

Before we get into these different changes, I want to point out that there are different tools out there that can improve your fibromyalgia symptoms. The biggest ones are heating pads, comfortable clothes, Icy Hot, and TENS units. 

Diet 

Like with all chronic illnesses, what food helps and hurts fibromyalgia depends wildly on the patient. However, here are some places to start.

First of all, everyone should aim for a well-rounded diet with protein, fruits, and vegetables (x). But if you’re already eating like that, you may need to look deeper. 

Look at gluten. You don’t have to have celiac disease to be intolerant to gluten! Healthline says, “People with fibromyalgia who tested negative for celiac disease still saw significant improvements in pain or quality-of-life indicators when following a gluten-free diet” (x). The American Fibromyalgia Syndrome Association points out that “A gluten-free diet involves the avoidance of wheat, barley, rye, spelt, Kamut, and triticale,” which is (obviously) more than just cutting out wheat (x). 

If you have no clue where to start with figuring out foods that irritate your fibromyalgia, you should try Whole30. Whole30 was a huge fad several years ago when people were looking for big-picture ways to eat healthier. But it’s a helpful tool for people with chronic illness who think their diet might be contributing and aren’t sure where to start. 

Basically, you cut out a lot of common problem foods for 30 days and then slowly reintroduce them to see how your body responds (x). In the original Whole30, the foods you cut out are added sugars, alcohol, grains, legumes, soy, peanuts, dairy, baked goods, pasta, cereal, chips, and fries (x). The plant-based Whole 30 is similar, except you also don’t eat meat, fish, or dairy (x).

The really important part of Whole30 is the reintroduction where you carefully reintroduce the different foods you cut out to see what your reaction is. As Whole30 says, “If you bring back pizza, beer, and ice cream all in the same meal, how will you know which food to blame if your energy, cravings, digestion, skin, or joints suffer?” (x).

This is where a lot of people go wrong. If you’re doing this for your health, you have to introduce them one at a time and in small doses. Whole30 says that this could take anywhere from 10 to 30 days, depending on how you do it. And “On reintroduction days, the rest of your meals should be Whole30 compatible to isolate the impact of that particular food group” (x). 

Through doing similar programs to Whole30 back in 2011 and 2015, I discovered that I can’t have gluten, dairy, soy, or eggs in any doses, but I can have corn in teeny tiny doses. When I was testing eggs, my mom made meatballs, which had 1 egg in 12 meatballs. I had such a strong reaction to having 1/12 of an egg that I was and am so grateful she did it that way. 

Also, definitely don’t reintroduce dairy and gluten by eating a big soft pretzel, fried dough, and ice cream all at a Red Sox game. If someone were to do that, they might spend the 2-hour ride back to Portland in extreme pain and scarring everyone in your family. Totally not talking about my experience in 2011, nope, definitely not …  

The point is also that you might not notice a significant improvement in your symptoms when you cut the foods out, but when you reintroduce them, you’ll be able to pinpoint how much of a reaction you have. 

Get The New Whole30 here.

Light exercise  

The NHS says, “It’s important to be physically active if you have fibromyalgia. This can be difficult if you’re in pain, but regular exercise has been shown to help reduce pain and improve overall quality of life” (x). 

Exercise can be really difficult with fibromyalgia because “At first, exercise may make your pain worse. But if you start slowly and become more active over time, it often relieves symptoms” (x). This is why light exercise is recommended for fibromyalgia.  

A 2018 study looked at Tai Chi versus aerobic exercise. 151 people with fibromyalgia participated in Tai Chi, while 75 were in an aerobic exercise group. While all saw some improvement in symptoms, “Tai chi treatment compared with aerobic exercise administered with the same intensity and duration (24 weeks, twice weekly) had greater benefit” (x). Additionally, “No serious adverse events related to the interventions were reported” (x). 

Now that I’ve cited my intellectual sources, let’s talk about how to do it. 

The American Fibromyalgia Syndrome Association has an incredible resource on fibro-friendly exercise. It explains different options and what they do for patients. 

Healthine also has an article on easing fibromyalgia pain with exercise. What I especially like about it is that it points out easy ways to incorporate moving into your life. You don’t have to sign up for a gym to move for fibromyalgia!

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How do you get a fibromyalgia diagnosis? 

Since many fibromyalgia symptoms can be connected to other illnesses, the only physical test specifically for fibromyalgia is a physical exam, looking at tender points. New York-Presbyterian says, “Tender points are specific sites on the body that cause pain when pressed. The pain may spread when a tender point is pressed and causes pain in a larger area (for example, down the leg, arm, or back)” (x). My rheumatologist checks my pain at tender points and joints in the same examination by pressing on them one at a time, at which point he also checks for inflammation.

Otherwise, doctors often order tests to eliminate other conditions, such as rheumatoid arthritis, lupus, or ME/CFS (Mayo). Those tests are generally blood work, urine tests, x-rays, CT scans, etc (NHS). Again, the only test that is specifically for fibromyalgia only is checking tender points; other tests look for conditions that could be causing your symptoms, and if those results come back normal, you likely have fibromyalgia. 

As you can see, rheumatologists are generally the doctors who treat fibromyalgia. If you don’t already have a rheumatologist, start with your PCP. They might order some of these tests and/or they could refer you to a rheumatologist. A pain medicine specialist might become part of your care team, but getting a fibromyalgia diagnosis will come from someone else (x). 

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Is fibromyalgia for real? 

I’m so sorry, but I saw this when searching for SEO keywords for this post, and it made me laugh, so I had to include it. 

But yes, fibromyalgia is for real. It’s a real condition and not something made up. Although I, too, want to tell my fibromyalgia, “Are you for real right now?” on a regular basis.

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Like this post? Share it! Then check out: 

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