Fibromyalgia and Fatigue

People who suffer from fibromyalgia have a lot to deal with. Not only do they often have intense pain, but research indicates that up to 90 percent of sufferers also suffer from fatigue—which can make the pain of the illness even harder to bear.

Fibromyalgia is a form of non-inflammatory arthritis that affects the muscles, tendons, and ligaments of the body. According to the Mayo Clinic, fibromyalgia occurs in about 2 percent of the population in the United States, and women are much more likely to develop the disorder than are men. Fibromyalgia symptoms often begin after a physical or emotional trauma, but in many cases there appears to be no triggering event.

Doctors and patients report that fybromyalgia can be quite debilitating because the intense pain that it causes all over the body can have a great impact on a person's ability to go to work, take care of their family, or even engage in simple daily tasks.

The fatigue that is common in those suffering from fibromyalgia heightens one's stress levels, which in turn increases the amount of pain that is experienced. According to the Arthritis Foundation, the fatigue can range from listlessness and decreased endurance to exhaustion.

Doctors report that the fatigue also has a great impact on the psychological well- being of those suffering from fibromyalgia.

Causes of Fatigue

New research is being performed to investigate the causes of this extreme fatigue. The following are some of the current theories.

Pain. Some doctors explain the fatigue of fibromyalgia as a result of the pain. To many this makes sense, except that at least 10 percent of sufferers report no problems with fatigue despite their pain. The overall consensus is that pain definitely contributes to fatigue, but it is probably not its underlying cause.

Chronic Fatigue Syndrome (CFS). The extreme fatigue that many fibromyalgia sufferers experience is very similar to that associated with chronic fatigue syndrome. CFS is usually diagnosed if the patient has experienced intense fatigue for a period of six months or longer. Some experts think that many people with fibromyalgia may actually have CFS as well.

Depression. Some researchers think there is a link between fibromyalgia and some forms of depression. One of the common symptoms of depression is fatigue.

Sleep Disorders. Researchers have been looking into the possibility that many fibromyalgia sufferers may actually have accompanying sleep disorders because so many people with the illness report extreme sleep disturbances. This includes such symptoms as: difficulty falling asleep, sleeping very lightly, suddenly awakening from a very deep sleep, or waking up tired even though they have had a full night's sleep.

"Improving a patient's sleep is an important part of easing fibromyalgia fatigue," says Mary Rose, PsyD, a clinical psychologist and behavioral sleep specialist at Baylor College of Medicine in Houston. The chronic lack of sleep affects a patient's overall health as well as their pain, Rose adds. "They feel lousy, exhausted, and their immune system can be damaged."

A recent study was conducted by Frederick Wolfe, MD., and a team of researchers. It aimed to develop simple, practical criteria for clinical diagnosis of fibromyalgia that are suitable for use in pimary and specialty care and that do not require a tender point exam. Its purpose was also to provide a severity scale for characteristic fibromyalgia symptoms (including fatigue). The findings that were drawn from this study will be especially useful in the longitudinal evaluation of patients with marked symptom variability.

Tips for Improving Sleep

  • Invest in a good, supportive mattress.
  • Make your bedroom as comfortable and quiet as possible (including a comfortable room temperature).
  • Set a consistent bedtime and wake-up time.
  • Avoid caffeine after 4pm, or alcohol before bed.
  • Limit napping. A quick cat-nap is okay, but longer than that can throw off your circadian rhythms.
  • Use your bedroom only for sleeping (or being romantic with your partner).
  • Before you get into bed, take a warm bath, listen to soothing music, or practice calming breathing exercises.
  • Dim the lights in the bedroom as you get ready for bed to make a calm transition toward sleep.
  • Turn the alarm clock away, so it's not facing you.
  • Take 10 long, slow deep breaths to ease yourself into sleep.


Burkhardt, C.S., Clark, S.R., O'Reilly, C.A., Bennet, R.M. Pain-coping Stragegies of Women with Fibromyalgia: Relationship to Pain, Fatigue, and Quality of Life. Journal of Musculoskeletal Pain. Volume 5, Number 3, August 1997, pages 5-21.

Good Living with Fibromyalgia. Atlanta, Georgia. Arthritis Foundation. 2006.

Information Page.

Information Page. Fibromyalgia.