Fact sheet

Fibromyalgia

Long-lasting pain in many parts of the body, with tiredness, unrefreshing sleep and trouble concentrating (“fibro fog”). It’s real: the nervous system turns up the volume on pain signals. It doesn’t damage joints or muscles, and gradually building up activity is the best-proven treatment.

Symptoms. Widespread aching and tenderness, stiffness, exhaustion, poor sleep, and memory and concentration problems. Headaches, irritable bowel, low mood and anxiety often come along too. Symptoms usually flare and ease over time.

Who gets it. About 2 in 100 people, more often diagnosed in women. It often sits alongside other conditions such as irritable bowel syndrome, migraine, depression or other long-term pain.

How it’s diagnosed. There’s no blood test or scan for it. Your GP diagnoses it from widespread pain lasting at least 3 months with fatigue, sleep and thinking problems, after an examination and a few blood tests to rule out look-alikes such as an underactive thyroid or inflammatory arthritis.

The fibromyalgia ladder

Step 1 is the foundation for everyone. Medicines help some people a modest amount, and work best alongside activity, not instead of it.

  1. Step 1 · Self-careGraded exerciseStart low and build slowly: walking, cycling, water exercise, plus some strength work. Increase by small steps every week or two.
    Works
    The only treatment European rheumatology experts strongly recommend. Pain about 11 points out of 100 lower than usual care, with better function (low-certainty evidence)
    Cost
    Free, or about $5–20 a session for a pool or gym
    How long
    8–12 weeks to feel it; keep going
    Watch for
    Doing too much on good days, then crashing. Aim for steady, not heroic.

    Start embarrassingly small. That’s the trick, not the cheat.

  2. Step 2 · Self-careTai chi, yoga, qigong or warm-water exerciseGentle movement classes, or exercise in a heated pool.
    Works
    A weak recommendation for: may help some people
    Cost
    Free online to about $15–25 a class
    How long
    8–12 weeks to judge
    Watch for
    Choose a beginner class and tell the teacher about your pain.

    Slow and steady counts as exercise.

  3. Step 3 · Allied healthPsychological therapy (such as CBT)A psychologist helps with sleep, pacing, mood and the stress that amplifies pain.
    Works
    A weak recommendation for: can help with coping, mood and sleep
    Cost
    About $150–250 a session; Medicare rebates for up to 10 sessions a year with a GP mental health plan
    How long
    6–10 sessions
    Watch for
    This isn’t saying the pain is “in your head”. Pain is processed in the brain for everyone.

    Rewiring the volume knob takes practice, not willpower.

  4. Step 4 · PrescriptionLow-dose amitriptyline at nightA small dose of an old antidepressant, used here for pain and sleep.
    Works
    In older, smaller trials, about 36 in 100 got half their pain gone, vs 11 in 100 on a dummy tablet
    Cost
    Under the $25 PBS co-payment
    How long
    4–6 weeks to judge
    Watch for
    Morning drowsiness, dry mouth, constipation, weight gain. Not with some heart conditions.

    A tiny dose, not a depression dose. Take it early in the evening to avoid the hangover.

  5. Step 5 · PrescriptionDuloxetineA daily medicine that affects pain signalling.
    Works
    About 34 in 100 got half their pain gone, vs 23 in 100 on a dummy tablet: about 1 extra person in 9 helped
    Cost
    Varies; may be a private script for fibromyalgia. Ask your pharmacist
    How long
    4–8 weeks to judge
    Watch for
    Nausea, sleep changes, sweating. Not with some other antidepressants. Stop slowly, with your GP.

    Helps a minority a lot. Worth a fair trial if exercise alone isn’t enough.

  6. Step 6 · PrescriptionPregabalinA nerve-calming medicine, sometimes tried when others haven’t helped.
    Works
    A weak recommendation for from European experts: helps a minority of people
    Cost
    Varies; ask your pharmacist
    How long
    4–8 weeks to judge
    Watch for
    Dizziness, drowsiness, weight gain, misuse risk. Not with alcohol or opioids.

    Fewer people helped than hoped. Review it honestly after a few months.

  7. Step 7 · SpecialistPain clinic programA team approach: doctor, physio, psychologist and others working together.
    Works
    A weak recommendation for, especially for severe disability
    Cost
    Public pain clinics are free (expect a wait); private programs vary
    How long
    Several weeks of sessions
    Watch for
    Bring a list of what you’ve tried and what helped.

    For when one tool isn’t enough and you need the whole toolbox.

Costs are rough Australian prices in November 2026 and vary by pharmacy and clinic. PBS co-payment: $25, or $7.70 with a concession card. Results are typical figures from trials, not promises.

Save your money

Popular, heavily marketed or often asked about, but the evidence is weak or says no.

What you can do

See your GP if

See a doctor promptly for swollen joints, fever, unexplained weight loss, a new rash, or true muscle weakness (not just aching or tiredness). These point to another cause.

If pain is making you feel hopeless or you’re thinking about suicide, call Lifeline on 13 11 14 (Australia), or your local crisis line, or 000 in an emergency.

Common questions

Is fibromyalgia real?

Yes. It’s a recognised condition in which the nervous system processes pain differently, so normal signals feel more painful. It isn’t imagined, and it isn’t a sign of weakness.

Will it damage my joints or muscles?

No. Fibromyalgia doesn’t cause joint damage or deformity. That’s also why exercise is safe and helpful.

Exercise makes me sore. Should I stop?

Not stop, but start smaller and build up more slowly. A little extra soreness that settles within a day or two is common. Steady, gentle increases work best.

Is there a cure?

Not yet, but many people improve with exercise, pacing, good sleep habits and, for some, medicine.

Helpful resources

Evidence and more information

Reviewed 1 November 2026. General education, not personal medical advice. Treatment depends on your situation, so talk to your GP or pharmacist.

Related

maladywise.com/fibromyalgia/