Questions

&Answers

about . . .

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

National Institutes of Health

Public Health Service • U.S. Department of Health and Human Services

Fibromyalgia
This booklet is not copyrighted. Readers are encouraged 

to duplicate and distribute as many copies as needed.

Additional copies of this booklet are available from:

National Institute of Arthritis and Musculoskeletal 

and Skin Diseases 

NIAMS/National Institutes of Health

1 AMS Circle

Bethesda, MD 20892–3675

You can also find this booklet on the NIAMS Web site at 

www.niams.nih.gov.

For Your Information

This publication contains information about medications 

used to treat the health condition discussed in this booklet. 

When this booklet was printed, we included the most 

up-to-date (accurate) information available. Occasionally, 

new information on medication is released.

For updates and for any questions about any medications 

you are taking, please contact the U.S. Food and Drug 

Administration at 1–888–INFO–FDA (1–888–463–6332, 

a toll-free call) or visit their Web site at www.fda.gov.

For updates and questions about statistics, please contact 

the Centers for Disease Control and Prevention’s National 

Center for Health Statistics toll free at 1–800–232–4636 or 

visit its Web site at www.cdc.gov/nchs.
Table of Contents

What Is Fibromyalgia? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Who Gets Fibromyalgia? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

What Causes Fibromyalgia? . . . . . . . . . . . . . . . . . . . . . . . . . . 3

How Is Fibromyalgia Diagnosed? . . . . . . . . . . . . . . . . . . . . . 4

How Is Fibromyalgia Treated? . . . . . . . . . . . . . . . . . . . . . . . . 6

Will Fibromyalgia Get Better With Time? . . . . . . . . . . . . . 12

What Can I Do to Try to Feel Better? . . . . . . . . . . . . . . . . . 12

What Are Researchers Learning 

About Fibromyalgia? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Where Can I Get More Information 

About Fibromyalgia? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Key Words . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Information Box

Tips for Good Sleep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Fibromyalgia

What Is Fibromyalgia? 

Fibromyalgia syndrome is a common and chronic disorder 

characterized by widespread muscle pain, fatigue, and 

multiple tender points. The word fibromyalgia comes from 

the Latin term for fibrous tissue (fibro) and the Greek ones 

for muscle (myo) and pain (algia). Tender points are specific 

places on the body – on the neck, shoulders, back, hips, and 

upper and lower extremities – where people with 

fibromyalgia feel pain in response to slight pressure.

Although fibromyalgia is often considered an arthritisrelated condition, it is not truly a form of arthritis (a disease 

of the joints) because it does not cause inflammation or 

damage to the joints, muscles, or other tissues. Like arthritis, 

however, fibromyalgia can cause significant pain and fatigue, 

and it can interfere with a person’s ability to carry on daily 

activities. Also like arthritis, fibromyalgia is considered a 

rheumatic condition. 

You may wonder what exactly rheumatic means. Even 

physicians do not always agree on whether a disease is 

considered rheumatic. If you look up the word in the 

dictionary, you’ll find it comes from the Greek word rheum, 

which means flux – not an explanation that gives you a 

better understanding. In medicine, however, the term 

rheumatic means a medical condition that impairs the joints 

and/or soft tissues and causes chronic pain.

1

Fibromyalgia
In addition to pain and fatigue, people who have 

fibromyalgia may experience:

•	 sleep disturbances

•	 morning stiffness

•	 headaches

•	 irritable bowel syndrome

•	 painful menstrual periods

•	 numbness or tingling of the extremities

•	 restless legs syndrome

•	 temperature sensitivity

•	 cognitive and memory problems (sometimes referred

to as “fibro fog”) 

•	 a variety of other symptoms.

Fibromyalgia is a syndrome rather than a disease. Unlike a 

disease, which is a medical condition with a specific cause 

or causes and recognizable signs and symptoms, a 

syndrome is a collection of signs, symptoms, and medical 

problems that tend to occur together but are not related to a 

specific, identifiable cause. 

2
Who Gets Fibromyalgia?

Scientists estimate that fibromyalgia affects 5 million 

Americans age 18 or older. For unknown reasons, between 

80 and 90 percent of those diagnosed with fibromyalgia are 

women; however, men and children also can be affected. 

Most people are diagnosed during middle age, although the 

symptoms often become present earlier in life.

People with certain rheumatic diseases, such as rheumatoid 

arthritis, systemic lupus erythematosus (commonly called 

lupus), or ankylosing spondylitis (spinal arthritis) may be 

more likely to have fibromyalgia, too. 

Several studies indicate that women who have a family 

member with fibromyalgia are more likely to have 

fibromyalgia themselves, but the exact reason for this 

– whether it be hereditary or caused by environmental 

factors or both – is unknown. One study supported by the 

National Institute of Arthritis and Musculoskeletal and Skin 

Diseases (NIAMS) is trying to identify whether certain genes 

predispose some people to fibromyalgia. (See “What Are 

Researchers Learning About Fibromyalgia?” on page 15.)

What Causes Fibromyalgia?

The causes of fibromyalgia are unknown, but there are 

probably a number of factors involved. Many people associate 

the development of fibromyalgia with a physically or 

3

Fibromyalgia
emotionally stressful or traumatic event, such as an 

automobile accident. Some connect it to repetitive injuries. 

Others link it to an illness. People with rheumatoid arthritis 

and other autoimmune diseases, such as lupus, are 

particularly likely to develop fibromyalgia. For others, 

fibromyalgia seems to occur spontaneously. 

Many researchers are examining other causes, including 

problems with how the central nervous system (the brain and 

spinal cord) processes pain. 

Some scientists speculate that a person’s genes may regulate 

the way his or her body processes painful stimuli. According 

to this theory, people with fibromyalgia may have a gene 

or genes that cause them to react strongly to stimuli that 

most people would not perceive as painful. However, those 

genes – if they, in fact, exist – have not been identified.

How Is Fibromyalgia Diagnosed?

Research shows that people with fibromyalgia typically see 

many doctors before receiving the diagnosis. One reason 

for this may be that pain and fatigue, the main symptoms of 

fibromyalgia, overlap with many other conditions. Therefore, 

doctors often have to rule out other potential causes of 

these symptoms before making a diagnosis of fibromyalgia. 

Another reason is that there are currently no diagnostic 

laboratory tests for fibromyalgia; standard laboratory tests 

fail to reveal a physiologic reason for pain. Because there is 

no generally accepted, objective test for fibromyalgia, some 

4
doctors unfortunately may conclude a patient’s pain is not 

real, or they may tell the patient there is little they can do.

A doctor familiar with fibromyalgia, however, can make a 

diagnosis based on two criteria established by the American 

College of Rheumatology (ACR): a history of widespread 

pain lasting more than 3 months and the presence of tender 

points. Pain is considered to be widespread when it affects 

all four quadrants of the body; that is, you must have pain 

in both your right and left sides as well as above and below 

the waist to be diagnosed with fibromyalgia. ACR also has 

5

Fibromyalgia

The location of the nine paired tender points that make up the 1990 

American College of Rheumatology criteria for fibromyalgia

This illustration is copyrighted by the Arthritis Foundation and may not be reproduced without permission.
designated 18 sites on the body as possible tender points. 

For a fibromyalgia diagnosis, a person must have 11 or more 

tender points. (See illustration on page 5.) One of these 

predesignated sites is considered a true tender point only if 

the person feels pain upon the application of 4 kilograms of 

pressure to the site. People who have fibromyalgia certainly 

may feel pain at other sites, too, but those 18 standard possible 

sites on the body are the criteria used for classification.

How Is Fibromyalgia Treated?

Fibromyalgia can be difficult to treat. Not all doctors are 

familiar with fibromyalgia and its treatment, so it is 

important to find a doctor who is. Many family physicians, 

general internists, or rheumatologists (doctors who specialize 

in arthritis and other conditions that affect the joints or soft 

tissues) can treat fibromyalgia. 

Fibromyalgia treatment often requires a team approach, 

with your doctor, a physical therapist, possibly other health 

professionals, and most importantly, yourself, all playing an 

active role. It can be hard to assemble this team, and you may 

struggle to find the right professionals to treat you. When 

you do, however, the combined expertise of these various 

professionals can help you improve your quality of life. 

You may find several members of the treatment team you 

need at a clinic. There are pain clinics that specialize in pain 

and rheumatology clinics that specialize in arthritis and other 

rheumatic diseases, including fibromyalgia.

6
In June 2007, the U.S. Food and Drug Administration (FDA) 

approved Lyrica* (pregabalin) as the first drug to treat 

fibromyalgia. Doctors also treat fibromyalgia with a variety of 

medications developed and approved for other purposes.

Following are some of the most commonly used categories of 

drugs for fibromyalgia.

Analgesics

Analgesics are painkillers. They range from over-the-counter 

acetaminophen (Tylenol) to prescription medicines, such as 

tramadol (Ultram), and even stronger narcotic preparations. 

For a subset of people with fibromyalgia, narcotic medications 

are prescribed for severe muscle pain. However, there is no 

solid evidence showing that narcotics actually work to treat 

the chronic pain of fibromyalgia, and most doctors hesitate to 

prescribe them for long-term use because of the potential that 

the person taking them will become physically or 

psychologically dependent on them.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

As their name implies, nonsteroidal anti-inflammatory drugs, 

including aspirin, ibuprofen (Advil, Motrin), and naproxen 

sodium (Anaprox, Aleve), are used to treat inflammation. 

Although inflammation is not a symptom of fibromyalgia, 

7

Fibromyalgia

* Brand names included in this booklet are provided as examples only, and their 

inclusion does not mean that these products are endorsed by the National Institutes 

of Health or any other Government agency. Also, if a particular brand name is not 

mentioned, this does not mean or imply that the product is unsatisfactory.
NSAIDs also relieve pain. The drugs work by inhibiting 

substances in the body called prostaglandins, which play a 

role in pain and inflammation. These medications, some of 

which are available without a prescription, may help ease 

the muscle aches of fibromyalgia. They may also relieve 

menstrual cramps and the headaches often associated 

with fibromyalgia.

Antidepressants

Perhaps the most useful medications for fibromyalgia are 

several in the antidepressant class. Antidepressants elevate 

the levels of certain chemicals in the brain, including 

serotonin and norepinephrine (which was formerly called 

adrenaline). Low levels of these chemicals are associated 

not only with depression, but also with pain and fatigue. 

Increasing the levels of these chemicals can reduce pain in 

people who have fibromyalgia. Doctors prescribe several 

types of antidepressants for people with fibromyalgia, 

described below. 

•	 Tricyclic antidepressants – When taken at bedtime 

in dosages lower than those used to treat depression, 

tricyclic antidepressants can help promote restorative 

sleep in people with fibromyalgia. They also can relax 

painful muscles and heighten the effects of the body’s 

natural pain-killing substances called endorphins. 

Tricyclic antidepressants have been around for almost 

half a century. Some examples of tricyclic medications 

used to treat fibromyalgia include amitriptyline 

8
hydrochloride (Elavil, Endep), cyclobenzaprine 

(Cycloflex, Flexeril, Flexiban), doxepin (Adapin, 

Sinequan), and nortriptyline (Aventyl, Pamelor). 

Both amitriptyline and cyclobenzaprine have been 

proven useful for the treatment of fibromyalgia.

•	 Selective serotonin reuptake inhibitors – If a tricyclic 

antidepressant fails to bring relief, doctors sometimes 

prescribe a newer type of antidepressant called a 

selective serotonin reuptake inhibitor (SSRI). As 

with tricyclics, doctors usually prescribe these for 

people with fibromyalgia in lower dosages than are 

used to treat depression. By promoting the release 

of serotonin, these drugs may reduce fatigue and 

some other symptoms associated with fibromyalgia. 

The group of SSRIs includes fluoxetine (Prozac), 

paroxetine (Paxil), and sertraline (Zoloft).

SSRIs may be prescribed along with a tricyclic 

antidepressant. Doctors rarely prescribe SSRIs alone. 

Because they make people feel more energetic, SSRIs 

also interfere with sleep, which often is already a 

problem for people with fibromyalgia. Studies have 

shown that a combination therapy of the tricyclic 

amitriptyline and the SSRI fluoxetine resulted in 

greater improvements in the study participants’ 

fibromyalgia symptoms than either drug alone. 

•	 Mixed reuptake inhibitors – Some newer 

antidepressants raise levels of both serotonin and 

9

Fibromyalgia
norepinephrine and are therefore called mixed reuptake 

inhibitors. Examples of these medications include 

venlafaxine (Effexor) and nefazodone (Serzone). 

Researchers are actively studying the efficacy of these 

newer medications in treating fibromyalgia.

Benzodiazepines

Benzodiazepines help some people with fibromyalgia 

by relaxing tense, painful muscles and stabilizing the 

erratic brain waves that can interfere with deep sleep. 

Benzodiazepines also can relieve the symptoms of restless 

legs syndrome, which is common among people with 

fibromyalgia. Restless legs syndrome is characterized by 

unpleasant sensations in the legs as well as twitching, 

particularly at night. Because of the potential for addiction, 

doctors usually prescribe benzodiazepines only for people 

who have not responded to other therapies. Benzodiazepines 

include clonazepam (Klonopin) and diazepam (Valium). 

Other Medications

In addition to the previously described general categories of 

drugs, doctors may prescribe others, depending on a person’s 

specific symptoms or fibromyalgia-related conditions. For 

example, in recent years, FDA has approved two medications 

– tegaserod (Zelnorm) and alosetron (Lotronex) – for 

the treatment of irritable bowel syndrome. Gabapentin 

(Neurontin) currently is being studied as a treatment for 

fibromyalgia. (See “What Are Researchers Learning About 

10
Fibromyalgia?” on page 15.) Other symptom-specific 

medications include sleep medications, muscle relaxants, and 

headache remedies. 

People with fibromyalgia also may benefit from a 

combination of physical and occupational therapy, from 

learning pain management and coping techniques, and from 

properly balancing rest and activity.

Complementary and Alternative Therapies

Many people with fibromyalgia also report varying degrees 

of success with complementary and alternative therapies, 

including massage, movement therapies (such as Pilates 

and the Feldenkrais method), chiropractic treatments, 

acupuncture, and various herbs and dietary supplements for

different fibromyalgia symptoms. (For more information on 

complementary and alternative therapies, contact the 

National Center for Complementary and Alternative 

Medicine. See “Where Can I Get More Information About 

Fibromyalgia?” on page 21.) 

Although some of these supplements are being studied 

for fibromyalgia, there is little, if any, scientific proof yet 

that they help. FDA does not regulate the sale of dietary 

supplements, so information about side effects, proper 

dosage, and the amount of a preparation’s active ingredient 

may not be well known. If you are using or would like to 

try a complementary or alternative therapy, you should first 

speak with your doctor, who may know more about the 

11

Fibromyalgia
therapy’s effectiveness, as well as whether it is safe to try in 

combination with your medications.

Will Fibromyalgia Get Better With Time?

Fibromyalgia is a chronic condition, meaning it lasts a long 

time – possibly a lifetime. However, it may comfort you to 

know that fibromyalgia is not a progressive disease. It is never 

fatal, and it won’t cause damage to your joints, muscles, or 

internal organs. In many people, the condition does improve 

over time.

What Can I Do to Try to Feel Better?

Besides taking medicine prescribed by your doctor, there are 

many things you can do to minimize the impact of 

fibromyalgia on your life. These include:

•	 Getting enough sleep – Getting enough sleep and 

the right kind of sleep can help ease the pain and 

fatigue of fibromyalgia. (See “Tips for Good Sleep” 

on page 14.) Even so, many people with fibromyalgia 

have problems such as pain, restless legs syndrome, 

or brainwave irregularities that interfere with 

restful sleep. 

•	 Exercising – Although pain and fatigue may make 

exercise and daily activities difficult, it’s crucial to 

12
be as physically active as possible. Research has 

repeatedly shown that regular exercise is one of the 

most effective treatments for fibromyalgia. People 

who have too much pain or fatigue to do vigorous 

exercise should begin with walking or other gentle 

exercise and build their endurance and intensity 

slowly. Although research has focused largely on the 

benefits of aerobic and flexibility exercises, a new 

NIAMS-supported study is examining the effects 

of adding strength training to the traditionally 

prescribed aerobic and flexibility exercises.

•	 Making changes at work – Most people with 

fibromyalgia continue to work, but they may have to 

make big changes to do so. For example, some people 

cut down the number of hours they work, switch to 

a less demanding job, or adapt a current job. If you 

face obstacles at work, such as an uncomfortable 

desk chair that leaves your back aching or difficulty 

lifting heavy boxes or files, your employer may make 

adaptations that will enable you to keep your job. An 

occupational therapist can help you design a more 

comfortable workstation or find more efficient and 

less painful ways to lift. 

If you are unable to work at all due to a medical 

condition, you may qualify for disability benefits 

through your employer or the Federal Government. 

Social Security Disability Insurance (SSDI) and 

Supplemental Security Insurance (SSI) are the largest 

13

Fibromyalgia
14

Tips for Good Sleep

n Keep regular sleep habits. Try to get to bed at the same time 

and get up at the same time every day – even on weekends 

and vacations.

n Avoid caffeine and alcohol in the late afternoon and evening. 

If consumed too close to bedtime, the caffeine in coffee, soft 

drinks, chocolate, and some medications can keep you from 

sleeping or sleeping soundly. Even though it can make you feel 

sleepy, drinking alcohol around bedtime also can disturb sleep.

n Time your exercise. Regular daytime exercise can improve 

nighttime sleep. But avoid exercising within 3 hours of bedtime, 

which actually can be stimulating, keeping you awake.

n Avoid daytime naps. Sleeping in the afternoon can interfere 

with nighttime sleep. If you feel you can’t get by without a 

nap, set an alarm for 1 hour. When it goes off, get up and 

start moving.

n Reserve your bed for sleeping. Watching the late news, reading 

a suspense novel, or working on your laptop in bed can 

stimulate you, making it hard to sleep. 

n Keep your bedroom dark, quiet, and cool. 

n Avoid liquids and spicy meals before bed. Heartburn and latenight trips to the bathroom are not conducive to good sleep. 

n Wind down before bed. Avoid working right up to bedtime. 

Do relaxing activities, such as listening to soft music or taking 

a warm bath, that get you ready to sleep. (A warm bath also 

may soothe aching muscles.)
Federal programs providing financial assistance to 

people with disabilities. Although the medical 

requirements for eligibility are the same under the 

two programs, the way they are funded is different. 

SSDI is paid by Social Security taxes, and those who 

qualify for assistance receive benefits based on how 

much they have paid into the system; SSI is funded 

by general tax revenues, and those who qualify receive 

payments based on financial need. For information 

about the SSDI and SSI programs, contact the Social 

Security Administration. (See “Where Can I Get 

More Information About Fibromyalgia?” on page 21.) 

•	 Eating well – Although some people with 

fibromyalgia report feeling better when they eat or 

avoid certain foods, no specific diet has been proven 

to influence fibromyalgia. Of course, it is important 

to have a healthy, balanced diet. Not only will 

proper nutrition give you more energy and make you 

generally feel better, it will also help you avoid other 

health problems.

What Are Researchers Learning About 

Fibromyalgia?

NIAMS sponsors research that will improve scientists’ 

understanding of the specific problems that cause or 

accompany fibromyalgia, in turn helping them develop better 

ways to diagnose, treat, and prevent this syndrome.

15

Fibromyalgia
The research on fibromyalgia supported by NIAMS covers 

a broad spectrum, ranging from basic laboratory research 

to studies of medications and interventions designed to 

encourage behaviors that reduce pain and change behaviors 

that worsen or perpetuate pain. 

Following are descriptions of some of the promising research 

now being conducted:

•	 Understanding pain – Research suggests that 

fibromyalgia is caused by a problem in how the body 

processes pain – or more precisely, a hypersensitivity 

to stimuli that normally are not painful. Therefore, 

several NIAMS-supported researchers are focusing on 

ways the body processes pain to better understand 

why people with fibromyalgia have increased 

pain sensitivity. 

Previous research has shown that people with 

fibromyalgia have reduced blood flow to parts of the 

brain that normally help the body deal with pain. In 

one new NIAMS-funded study, researchers will be 

using imaging technology called positron emission 

tomography (PET) to compare blood flow in the 

brains of women who have fibromyalgia with those 

who do not. In both groups, researchers will study 

changes in blood flow that occur in response to 

painful stimuli. 

16
Researchers speculate that female reproductive 

hormones may be involved in the increased sensitivity 

to pain characteristic of fibromyalgia. New research 

will examine the role of sex hormones in pain 

sensitivity, in reaction to stress, and in symptom 

perception at various points in the menstrual cycles of 

women with fibromyalgia and of women without it. 

The results from studying these groups of women 

will be compared with results from studies of the 

same factors in men without fibromyalgia over an 

equivalent period of time. 

Another line of NIAMS-funded research involves 

developing a rodent model of fibromyalgia pain. 

Rodent models, which use mice or rats that 

researchers cause to develop symptoms similar to 

fibromyalgia in humans, could provide the basis for 

future research into this complex condition.

•	 Understanding stress – Medical evidence suggests 

that a problem or problems in the way the body 

responds to physical or emotional stress may trigger 

or worsen the symptoms of any illness, including 

fibromyalgia. Researchers funded by NIAMS are 

trying to uncover and understand these problems 

by examining chemical interactions between the 

nervous system and the endocrine (hormonal) 

system. Scientists know that people whose bodies 

make inadequate amounts of the hormone cortisol 

17

Fibromyalgia
experience many of the same symptoms as people 

with fibromyalgia, so they also are exploring whether 

there is a link between the regulation of the adrenal 

glands, which produce cortisol, and fibromyalgia. 

Another NIAMS-funded study suggests that exercise 

improves the body’s response to stress by enhancing 

the function of the pituitary and adrenal glands. The 

hormones produced by these two endocrine glands 

are essential to regulating sleep and emotions as well 

as processing pain.

•	 Improving sleep – Researchers supported by NIAMS 

are investigating ways to improve sleep for people 

with fibromyalgia whose sleep problems persist 

despite treatment with medications. One team has 

observed that fibromyalgia patients with persistent 

sleep problems share characteristics with people 

who have insomnia, such as having erratic sleep and 

wake schedules and spending too much time in bed. 

This team is testing whether strategies developed to 

help insomnia patients will also help people with 

fibromyalgia achieve deep sleep, which eases pain 

and fatigue. Preliminary results show that sleep 

education, which teaches good sleep habits, and 

cognitive behavioral therapy, which includes sleep 

education and a regimen to correct poor habits and 

improper sleep schedules, both reduce insomnia.

18
•	 Looking for the family connection – Because 

fibromyalgia appears to run in families, one group 

of NIAMS-supported researchers is working to 

identify whether a gene or genes predispose people to 

the condition. 

Another team is trying to determine whether 

fibromyalgia is more common in people with other 

conditions, such as serious mood disorders, that tend 

to run in families. Specifically, the group is studying 

the prevalence of psychiatric disorders and arthritis 

and related disorders in people with fibromyalgia 

and their first-degree relatives (parents, children, 

sisters, and brothers) as compared to people with 

rheumatoid arthritis and their relatives. The group 

is exploring whether clusters of conditions exist 

in families, which might shed light on shared risk 

factors or disease processes. 

•	 Studying and targeting treatments – NIAMS recently

funded its first study of a drug treatment for

fibromyalgia. The study will measure the effectiveness 

of gabapentin, an anticonvulsant medication, in 

reducing symptoms of fibromyalgia. Gabapentin has 

been found to relieve chronic pain caused by nervous 

system disorders, and it was recently approved by 

FDA for the treatment of persistent, severe pain that 

can follow an episode of shingles. 

19

Fibromyalgia
Scientists recognize that people with fibromyalgia 

often fall into distinct subgroups that adapt to 

and cope with their symptoms differently. They 

also realize that these subgroups may respond to 

treatments differently. One NIAMS-funded team 

of researchers has divided people with fibromyalgia 

into three groups based on how they cope with the 

condition. Relative to other chronic pain patients, 

those in the first group have higher levels of pain 

and report more interference in their life due to pain. 

They also have higher levels of emotional distress, 

feel less control over their lives, and are less active. 

The second group reports receiving less support 

from others, higher levels of negative responses from 

significant others, and lower levels of supportive 

responses from significant others. Those in the third 

group are considered adaptive copers; they have less 

pain, report less interference in their lives due to pain, 

and have less emotional distress. Members of this last 

group feel more control over their lives and are more 

active. On the premise that the better you understand 

the subgroups, the better you can tailor treatments to 

fit them, the researchers now are trying to design and 

test different programs for each group, combining 

physical therapy, interpersonal skills training, and 

supportive counseling. 

20
Where Can I Get More Information About 

Fibromyalgia?

n National Institute of Arthritis and Musculoskeletal 

and Skin Diseases (NIAMS)

National Institutes of Health

1 AMS Circle

Bethesda, MD 20892–3675

Phone: 877–22–NIAMS (226–4267) (free of charge)

TTY: 301–565–2966

Fax: 301–718–6366

E-mail: NIAMSinfo@mail.nih.gov

www.niams.nih.gov 

n National Center for Complementary and 

Alternative Medicine

National Institutes of Health

P.O. Box 7923

Gaithersburg, MD 20898–7923

Phone: 888–644–6226 (free of charge)

TTY: 866–464–3615 (free of charge)

Fax: 866–464–3616 (free of charge)

E-mail: info@nccam.nih.gov

www.nccam.nih.gov

n Social Security Administration

Office of Public Inquiries

Windsor Park Building

6401 Security Boulevard

Baltimore, MD 21235

Phone: 800–772–1213 (free of charge)

TTY: 800–325–0778 (free of charge)

www.ssa.gov/disability

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Fibromyalgia
n American College of Rheumatology/Association of 

Rheumatology Health Professionals

1800 Century Place, Suite 250

Atlanta, GA 30345–4300

Phone: 404–633–3777

Fax: 404–633–1870

www.rheumatology.org

n Advocates for Fibromyalgia Funding, Treatment, 

Education, and Research

P.O. Box 768

Libertyville, IL 60048–0768

Phone: 847–362–7807

Fax: 847–680–3922

E-mail: info@affter.org

www.affter.org

n Fibromyalgia Network

P.O. Box 31750

Tucson, AZ 85751–1750

Phone: 800–853–2929 (free of charge)

Fax: 520–290–5550

E-mail: inquiry@fmnetnews.com 

www.fmnetnews.com 

n National Fibromyalgia Association 

2121 S. Towne Centre Place, Suite 300

Anaheim, CA 92806 

Phone: 714–921–0150 

Fax: 714–921–6920

www.fmaware.org 

Tenemos disponible información en español y 

personal bilingüe.

22
n National Fibromyalgia Partnership, Inc.

P.O. Box 160

Linden, VA 22642–0160

Phone: 866–725–4404 (free of charge)

Fax: 866–666–2727 (free of charge) or 540–622–2998

E-mail: mail@fmpartnership.org

www.fmpartnership.org

n Arthritis Foundation

P.O. Box 7669

Atlanta, GA 30357–0669

Phone: 800–283–7800 (free of charge) or call your local 

chapter (To find your local chapter, check your phone 

directory or visit the foundation’s Web site.) 

www.arthritis.org

23

Fibromyalgia
Key Words

Adrenal glands – A pair of endocrine glands located on the 

surface of the kidneys. The adrenal glands produce 

corticosteroid hormones such as cortisol, aldosterone, and 

the reproductive hormones.

Analgesic – A medication or treatment that relieves pain.

Arthritis – Literally means joint inflammation, but is often 

used to indicate a group of more than 100 rheumatic 

diseases. These diseases affect not only the joints but also 

other connective tissues of the body, including important 

supporting structures, such as muscles, tendons, and 

ligaments, as well as the protective covering of 

internal organs.

Chronic disease – An illness that lasts for a long time, often 

a lifetime.

Connective tissue – The supporting framework of the body 

and its internal organs.

Cortisol – A hormone produced by the adrenal cortex, 

important for normal carbohydrate metabolism and for a 

healthy response to stress.

Fibromyalgia – A chronic syndrome that causes pain and 

stiffness throughout the connective tissues that support and 

move the bones and joints. Pain and localized tender points 

occur in the muscles, particularly those that support the neck, 

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spine, shoulders, and hips. The disorder includes widespread 

pain, fatigue, and sleep disturbances.

Fibrous capsule – A tough wrapping of tendons and 

ligaments that surrounds the joint.

Inflammation – A characteristic reaction of tissues to injury 

or disease. It is marked by four signs: swelling, redness, heat, 

and pain. Inflammation is not a symptom of fibromyalgia.

Joint – A junction where two bones meet. Most joints are 

composed of cartilage, joint space, fibrous capsule, synovium, 

and ligaments.

Ligaments – Bands of cordlike tissue that connect bone 

to bone.

Muscle – A structure composed of bundles of specialized 

cells that, when stimulated by nerve impulses, contract and 

produce movement.

Nonsteroidal anti-inflammatory drugs (NSAIDs) – A 

group of drugs, such as aspirin and aspirin-like drugs, used 

to reduce inflammation that causes joint pain, stiffness, 

and swelling.

Pituitary gland – A pea-sized gland attached beneath the 

hypothalamus at the base of the skull that secretes many 

hormones essential to bodily functioning. The secretion of 

pituitary hormones is regulated by chemicals produced in 

the hypothalamus. 

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Fibromyalgia
Sleep disorder – A disorder in which a person has difficulty 

achieving restful, restorative sleep. In addition to other 

symptoms, people with fibromyalgia usually have 

a sleep disorder.

Tender points – Specific places on the body where a person 

with fibromyalgia feels pain in response to slight pressure.

Tendons – Fibrous cords that connect muscle to bone.

Acknowledgments

NIAMS gratefully acknowledges the assistance of Deborah Ader, Ph.D., NIAMS, 

NIH; Karen Amour and Lynne Matallana, National Fibromyalgia 

Association, Orange, CA; Michele L. Boutaugh, M.P.H., Arthritis Foundation, 

Atlanta, GA; Daniel Clauw, M.D., and Leslie Crofford, M.D., University of 

Michigan, Ann Arbor; and Tamara Liller, National Fibromyalgia Partnership, 

Linden, VA, in the preparation of this booklet.

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The mission of the National Institute of Arthritis and 

Musculoskeletal and Skin Diseases (NIAMS), a part of the 

U.S. Department of Health and Human Services’ National 

Institutes of Health (NIH), is to support research into the 

causes, treatment, and prevention of arthritis and 

musculoskeletal and skin diseases; the training of basic and 

clinical scientists to carry out this research; and the 

dissemination of information on research progress in these 

diseases. The NIAMS Information Clearinghouse is a 

public service sponsored by the Institute that provides health 

information and information sources. Additional information 

can be found on the NIAMS Web site at www.niams.nih.gov.
U.S. Department of Health and Human Services

Public Health Service

National Institutes of Health

National Institute of Arthritis and 

Musculoskeletal and Skin Diseases

NIH Publication No. 04–5326

June 2004