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Fibromyalgia (FMS)

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Autoimmune Thyroid Disease and FMS
Interstitial Cystitis
Sleep Disorders/RLS
Medical: Pain
Personal Stories

Overview: What is Fibromyalgia (FMS)?

Fibromyalgia KaleidoscopeFibromyalgia (FMS) causes chronic pain, fatigue, disturbed sleep and a myriad of other symptoms. It can occur by itself or along with other forms of arthritis, including scleroderma. Although it is never fatal, it is usually difficult to manage and can cause significant disability and disruption of quality of life.


Causal attributions of potentially traumatic life events in fibromyalgia patients. Potentially traumatic life events could remain undetected in primary healthcare consultations and hypnosis could prove a useful tool for their detection. PubMed, Int J Rheum Dis, 10/29/2019.

The role of human herpes virus-6 (HHV-6) and human herpes virus-7 (HHV-7) infections in the development of fibromyalgia. No difference was found between detection frequency of persistent HHV-6 and HHV-7 infection between FM patients and the control group. PubMed, J Neurovirol, 01/07/2019.

Effects of vitamin D optimization on quality of life of patients with fibromyalgia (FMS): A randomized controlled trial. This study suggests that vitamin D supplementation has significant therapeutic benefits in the management of FMS, especially in pain reduction of patients with fibromyalgia. PubMed, Med J Islam Repub Iran, 2018 Apr 5;32:29.

Sympathetic nervous system dysfunction in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis. Sympathetic dysfunction could be the common underlying pathogenesis that brings on these overlapping clinical features. PubMed, J Clin Rheumatol. (Also see Chronic Fatigue Syndrome, Irritable Bowel Syndrome and Interstitial Cystitis)


Fibromyalgia symptoms or not? Understand the fibromyalgia diagnosis process. Fibromyalgia symptoms include widespread body pain, fatigue, poor sleep and mood problems. And because fibromyalgia symptoms can occur alone or along with other diseases, it can take time to tease out which symptom is caused by what problem. Mayo Clinic.

Beyond bones: The relevance of variants of connective tissue (hypermobility) to fibromyalgia, ME/CFS and controversies surrounding diagnostic classification: an observational study. Symptomatic hypermobility is particularly relevant to fibromyalgia and ME/CFS, and our findings highlight high rates of mis–/underdiagnosis. PubMed, Clin Med (Lond), 2021 Jan;21(1):53-58. (Also see Chronic Fatigue Syndrome)

Sifting the Wheat From the Chaff? Evidence for the Existence of an Asymmetric Fibromyalgia Phenotype. Within the current FM criteria, there exist different phenotypes with clinical, psychophysics, and neurophysiological findings. PubMed, Eur J Pain, 06/13/2020.

Electrodiagnostic Abnormalities Associated with Fibromyalgia. In addition to skin punch biopsies to assess small fiber neuropathy, assessment of the anal reflex may be a useful part of the diagnostic pathway in patients with fibromyalgia. Dovepress, Journal of Pain Research, 04/09/2020.

Serum levels of serotonin as a biomarker of newly diagnosed fibromyalgia (FM) in women: Its relation to the platelet indices. This study highlighted that the correction of serum serotonin level by medicines could help the FM patients. PubMed, J Res Med Sci, 2018 Aug 23;23:71.


Alternative Therapies
Cognitive Therapy
Low Level Laser
Peripheral Nerve Stimulation
Transcranial Stimulation


Fibromyalgia Complications Fibromyalgia symptoms may come and go, but the pain syndrome can disrupt your life and is often associated with other diseases. Healthline.

Fibromyalgia (FM) as a Predictor of Increased Postoperative Complications, Readmission Rates, and Hospital Costs in Patients Undergoing Posterior Lumbar Spine Fusion. Primary 1 to 2 level lumbar fusions performed on FM patients have higher rates of postoperative anemia, pneumonia, cost of care, and readmission compared to match controls. PubMed, Spine (Phila Pa 1976), 2019 Feb 15;44(4):E233-E238.

Autoimmune, Arthritis or Rheumatic

Autoimmune Diseases. Fibromyalgia may occur by itself or along with any other autoimmune, arthritis or rheumatic disorder, including scleroderma. ISN.

The Frequency of Fibromyalgia (FM) and its Relationship With Disease Activity in Female Patients With Behçet's Disease (BD): A Cross Sectional Study. Disease activity is higher in female BD patients with FM than those without FM. PubMed, Arch Rheumatol, 2020 Jan 8;35(3):401-408. (Also see Behçet's Disease)

Inflammation is associated with pro-nociceptive brain connections in rheumatoid arthritis (RA) patients with concomitant fibromyalgia (FM). Here we provide the first neurobiological evidence that comorbid FM in RA may be linked to peripheral inflammation through pro-nociceptive patterns of brain connectivity. PubMed, Arthritis Rheumatol, 08/05/2019. (Also see Symptoms and Complications of Rheumatoid Arthritis)

Patients with fibromyalgia (FM) rarely fulfil classification criteria for axial spondyloarthritis (axSpA). FM patients only rarely fulfil classification criteria for axSpA but some axSpA patients also fulfil FM criteria and assessment instruments evaluated in axSpA are not disease–specific. PubMed, Rheumatology (Oxford), 2018 Sep 1;57(9):1541-1547.

Autoimmune Thyroid Disease and Fibromyalgia

Rheumatic associations of autoimmune thyroid disease (AITD): a systematic review. The rheumatic associations of AITD may manifest specific patterns of disease distinct from those of other well-defined autoimmune syndromes and contribute significantly to disease burden. PubMed, Clin Rheumatol, 2019 Jul;38(7):1801-1809. (Also see Autoimmune Thyroid Disease)

Cardiac Autonomic Dysfunction

Comparison of heart rate variability (HRV) and classic autonomic testing for detection of cardiac autonomic dysfunction (CAD) in patients with fibromyalgia. HRV does not improve detection of CAD in FM patients over classic autonomic testing. PubMed, Int J Rheum Dis, 2018 Apr;21(4):804-812.


Prevalence of fibromyalgia among women with deep infiltrating endometriosis (DIE). The estimated prevalence of fibromyalgia was higher among women with DIE and women with DIE and positive fibromyalgia screening had lower health–related quality of life. PubMed, Int J Gynaecol Obstet, 04/11/2019.


Prevalence of anxiety, depression, sleep disturbance, fibromyalgia, obesity, and gastroesophageal disease in patients with rheumatic diseases. Fibromyalgia was found to be related to higher disease activity scores. PubMed, Curr Rheumatol Rev, 12/11/2020. (Also see Reflux (Heartburn) and GERD)

Dietary interventions in Fibromyalgia (FM): a systematic review. Well–designed studies should be performed to investigate the dietary interventions effect on FM. PubMed, Ann Med, 2019 Feb 8:1-29.

Interstitial Cystitis (Bladder) and Fibromyalgia

Interstitial Cystitis and Fibromyalgia. A subset of interstitial cystitis (IC) patients also have fibromyalgia (FM), a chronic pain disorder with a multitude of symptoms. Interstitial Cystitis Association.

Lupus and Fibromyalgia

Lupus. It is common for people with lupus (and other autoimmune diseases) to be initially diagnosed with fibromyalgia. ISN.

Lupus in Overlap
Media Stories
Pediatric Lupus
Personal Stories

Irritable bowel syndrome (IBS)-type symptoms in female patients with mild systemic lupus erythematosus (SLE): frequency, related factors and quality of life. IBS-type symptoms are highly prevalent among women with SLE and are associated with fibromyalgia (FM) and depression. SLE+IBS patients had worse quality of life (HRQOL) vs Non-IBS SLE, independently of FM status. Treating IBS symptoms may improve HRQOL in women with SLE. PubMed, Neurogastroenterol Motil. (Also see Systemic Lupus Erythematosus and Depression)


Risk of hearing loss (HL) in patients with fibromyalgia (FM): A nationwide population-based retrospective cohort study. Our findings support the notion that FM influences HL and is in line with the hypothesis that the FM mechanism is related to a central nervous system abnormality in sensory processing. PubMed, PLoS One, 2020 Sep 3;15(9):e0238502.

Frequency of audiological complaints in patients with fibromyalgia syndrome (FMS) and its relationship with oxidative stress. Patients with FMS have high levels of oxidative stress markers, highly frequent audiological symptoms with high hearing frequencies in audiometry, independent of disease severity. PubMed, Niger J Clin Pract, 2018 Oct;21(10):1271-1277. (Also see Oxidative Stress)


Aberrant salience? Brain hyperactivation in response to pain onset and offset in fibromyalgia (FM). Our results suggest that the increased sensitivity exhibited by FM patients in response to painful stimuli may reflect a more generalized hypersensitivity to salient sensory events. PubMed, Arthritis Rheumatol, 02/03/2020.

Reduction of skin innervation is associated with a severe fibromyalgia (FMS) phenotype. The extent of small fiber pathology is related to symptom severity in FMS and may have implications for the diagnostic classification and treatment of patients with FMS. PubMed, Ann Neurol, 2019 Oct;86(4):504-516.

Migraine and Fibromyalgia

Fibromyalgia in migraine: a retrospective cohort study. Patients with comorbid fibromyalgia and migraine report more depressive symptoms, higher headache intensity, and are more likely to have severe headache related disability as compared to controls without fibromyalgia. PubMed, J Headache Pain, 2018 Jul 31;19(1):61.

Premenstrual Syndrome

Premenstrual syndrome (PMS) and fibromyalgia (FMS) may be related; in fact, PMS is listed as a symptom of fibromyalgia. However, a person can have PMS without having FMS.

Sjögren's Syndrome

Prevalence and clinical impact of fibromyalgia (FM) in patients with primary Sjögren's syndrome (pSS). The study showed that FM was prevalent in pSS and FM was associated with higher EULAR Sjögren's Syndrome Patient Reported Index and more severe depression. PubMed, Clin Exp Rheumatol. (Also see Symptoms and Complications of Sjögren's Syndrome)

Sleep Disorders

Painful Sleep: Insomnia in Patients with Chronic Pain Syndrome and its Consequences. The purpose of this article is to review the diagnosis and management of insomnia in chronic pain syndrome and its impact on the quality of life. PubMed, Folia Med (Plovdiv), 2020 Dec 31;62(4):645-654. (Also see Depression)

The Association of Body Mass Index (BMI) and Body Composition with Pain, Disease Activity, Fatigue, Sleep and Anxiety in Women with Fibromyalgia. The promotion of an optimal BMI might contribute to ameliorate some of the FMS symptoms. PubMed, Nutrients, 2019 May 27;11(5):1193. (Also see Sleep Apnea and Associated Diseases)

The role of oxidative stress in the relation between fibromyalgia (FMS) and obstructive sleep apnea syndrome (OSAS). OSAS and FMS were highly prevalent, which indicated that oxidative stress might play a role in the pathophysiology of both diseases, especially if they co–exist in the same patient. PubMed, Eur Rev Med Pharmacol Sci. (Also see Sleep Apnea and Oxidative Stress)

Scleroderma and Fibromyalgia

About half of people with fibromyalgia have Raynaud's. Occasionally Raynaud's is secondary to connective tissue diseases, such as scleroderma. (Also see What is Scleroderma? and Raynaud's)

Temporomandibular Joint Disorder and Fibromyalgia

Features of temporomandibular disorders in fibromyalgia syndrome. Facial pain was reported by 85% of the fibromyalgia group, and 77.5% were diagnosed with myofascial temporomandibular disorders TMD. ProHealth. Cranio.

Relationship Between (CFS) and Fibromyalgia (FMS)

Predictors of New Onsets of Irritable Bowel Syndrome (IBS), Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM): The Lifelines Study. The close relationship between IBS and FM is striking and requires further research. PubMed, Psychol Med, 2020 Jun 17;1-9. (Also see Bowel Dysfunction and Chronic Fatigue Syndrome)

Fibromyalgia and Chronic Fatigue Information on the relationships between the rheumatological condition known as fibromyalgia, fibrositis, or FMS, chronic fatigue syndrome, CFS, myalgic encephalitis, ME, hypometabolism and thyroid disease, including hypothyroidism. VeryWell.

Disability Information for Fibromyalgia

CFS/FMS Objective Medical Evidence Requirements for Disability Adjudication Regarding Social Security Disability in the U.S. Susan M. Daniels, Ph. D.


The relationship between body mass index and pain, disease activity, depression and anxiety in women with fibromyalgia (FMS). Obese female FMS patients had higher levels of pain, tender point count, disease activity and depression. PubMed, PeerJ, 2018 May 28;6:e4917.

The impact of thyroid autoimmunity on arterial stiffness in postmenopausal patients with fibromyalgia (FB). Age, functional status and presence of thyroidperoxidase autoantibody were significantly associated with increased arterial stiffness in postmenopausal FM patients. PubMed, Int J Rheum Dis.

FMS: Psychological and Sociological Research

Modifiable Psychological Factors Affecting Functioning in Fibromyalgia. Our findings suggest that pain catastrophizing appears to be an especially important variable contributing to reduced functioning and so catastrophizing-reducing treatments (e.g., cognitive behavioral therapy) are likely to have direct, beneficial impacts on functioning. PubMed, J Clin Med, 2021 Feb 17;10(4):803.

The Co-Morbidity between Bipolar and Panic Disorder (comBD/PD) in Fibromyalgia (FM) Syndrome. These findings support the hypothesis that comBD/PD is related to the development of FM in a subgroup of patients. PubMed, J Clin Med, 2020 Nov 10;9(11):E3619.

Adult attention deficit hyperactivity disorder (ADHD) in patients with fibromyalgia syndrome: Assessment and disabilities. Results suggest that ADHD can increase burden adding specific disability in work and social activities, and it is associated with a trend for the excessive use of opioid painkillers. PubMed, J Psychiatr Res, 2020 Oct 24;S0022-3956(20)31030-X.

Outpatient Engagement Lowers Predicted Risk of Suicide Attempts in Fibromyalgia (FM). This is the first study to successfully apply machine learning to reliably detect suicidality in FM, identifying novel risk factors for suicidality and highlighting outpatient engagement as a protective factor against suicide. PubMed, Arthritis Care Res (Hoboken), 09/07/2018. (Also see Suicide Prevention)

Paresthesia frequency in fibromyalgia and its effects on personality traits. These results suggest that psychological distress associated with high harm avoidance and low self–directedness scores are more prominent in fibromyalgia patients and especially of those who have paresthesia. PubMed, Int J Rheum Dis, 2018 Jul;21(7):1343-1349.

The effect of depressive symptoms on cognition in patients with fibromyalgia (FM). FM patients show a cluster of cognitive impairment in the attentional and executive domains; some of the symptoms could be explained by depression, while others seem to depend on fibromyalgia. PubMed, PLoS One, 2018 Jul 5;13(7):e0200057. (Also see Depression)

Medical Research: Pain

Association of Therapies With Reduced Pain and Improved Quality of Life in Patients With Fibromyalgia: A Systematic Review and Meta-analysis. This systematic review and meta–analysis suggests that most of the currently available therapies for the management of fibromyalgia are not supported by high–quality evidence. PubMed, JAMA Intern Med, 2021 Jan 1;181(1):104-112.

Pulsed electromagnetic field (PEMF) therapy in the treatment of pain and other symptoms in fibromyalgia: A randomized controlled study. This study demonstrated that low–energy PEMF therapy was not efficient in reducing pain and stiffness or in improving functioning in women with fibromyalgia. PubMed, Bioelectromagnetics, 04/30/2018.

Pain and emotion as predictive factors of interoception in fibromyalgia (FM). Pain–related affect and reactions in FM patients can reduce their interoceptive ability and our results help to better understand the integration between bodily signals and emotional processing in chronic pain. PubMed, J Pain Res, 2018 Apr 19;11:823-835.

Why Tai Chi Works So Well For Pain Relief. In a new study published in the BMJ, researchers report encouraging results involving one way to reduce the painful effects of fibromyalgia: with tai chi, an ancient practice originating in martial arts. Times Healthland, 03/22/2018.


The National Fibromyalgia & Chronic Pain Association strategically focuses on issues facing people with life-altering chronic pain issues.

Personal Stories

FMS Stories in English and Español/Spanish

Go to CFS/Fibromyalgia Patient Stories

SCLERO.ORG was the world's leading nonprofit for trustworthy research, support, education and awareness for scleroderma and related illnesses from 1998 to 2021. It was a grassroots movement from the original Scleroderma from A to Z web site, which was founded by Shelley Ensz. We were a 501(c)(3) U.S.-based public charitable foundation. We closed this web site and our nonprofit agency in April 2021.

International Scleroderma Network (ISN)