What is fibromyalgia?
Fibromyalgia is a chronic pain condition in which the central nervous system processes pain signals abnormally, effectively turning up the volume on pain. The result is persistent widespread pain and tenderness, profound fatigue, unrefreshing sleep and difficulties with memory and concentration often called 'fibro fog'. Symptoms fluctuate, and flares can be triggered by stress, poor sleep, weather or overexertion.
Fibromyalgia is estimated to affect up to 1 in 20 people to some degree, most often women between 30 and 60, and frequently coexists with conditions such as irritable bowel syndrome and migraine. There is no diagnostic blood test or scan: diagnosis is clinical, based on widespread pain lasting more than three months alongside characteristic symptoms, with tests used to exclude inflammatory arthritis, thyroid disease and other mimics.
Common symptoms
- Widespread pain affecting both sides of the body
- Deep fatigue despite sleep
- Unrefreshing, easily disturbed sleep
- Cognitive difficulties ('fibro fog')
- Heightened sensitivity to touch, noise or temperature
- Morning stiffness
- Headaches and irritable bowel symptoms
How long will you wait?
Routine NHS rheumatology referrals typically take three to six months in many areas, with further waits of months for pain management programmes.
Privately, you can typically see a consultant rheumatologist or pain specialist within 3–7 days.
NHS England median referral-to-treatment wait: 12.4 weeks, with 2.5 million people waiting over 18 weeks (May 2026). Individual waits vary by trust and urgency.
Treatment options
- Education and self-management. Understanding the condition, pacing activity and managing flares — the foundation of every effective plan.
- Graded exercise and physiotherapy. Gentle, gradually built aerobic and strengthening activity, one of the best-evidenced treatments.
- Medication for pain and sleep. Low-dose amitriptyline, duloxetine or pregabalin in selected patients; standard painkillers and opioids help little.
- Psychological therapies. CBT and acceptance-based approaches that reduce pain's grip on daily life.
- Multidisciplinary pain programmes. Combined clinics bringing these strands together for people with significant impact.
What does private treatment cost?
As a guide, a private rheumatology consultation costs around £250–£350, screening blood tests £100–£300, and physiotherapy or psychology sessions £60–£150 each.
Does health insurance cover fibromyalgia?
Insurers usually cover the consultations and tests needed to reach a diagnosis and exclude inflammatory conditions such as rheumatoid arthritis. Once fibromyalgia is confirmed, it is generally classed as a chronic condition, so long-term management — ongoing therapy, pain programmes and repeat reviews — typically falls outside cover. Some policies will fund limited courses of physiotherapy or psychological therapy under their standard outpatient or mental health limits.
Frequently asked questions
Is fibromyalgia a real, physical condition?
Yes. Research consistently shows measurable differences in how the central nervous system processes pain in fibromyalgia, including on functional brain imaging. It is recognised by the NHS, NICE and the World Health Organization. The pain is genuine and physical — it originates in the nervous system's amplification of signals rather than damage in the tissues where pain is felt, which is why standard painkillers work poorly.
Why has my doctor stopped prescribing strong painkillers?
Because the evidence shows opioids do not work well for fibromyalgia and cause real harm with long-term use — dependence, worsening pain sensitivity and side effects. Current guidance instead supports exercise, psychological approaches and, in some people, specific medicines such as duloxetine or amitriptyline that act on pain processing. If your current plan is not helping, ask about referral to a pain management programme.
Will fibromyalgia get worse over time?
Fibromyalgia is not a progressive disease: it does not damage joints, muscles or organs, and it does not shorten life. Symptoms typically wax and wane, and many people improve meaningfully with the right combination of paced exercise, sleep management and psychological strategies. Flares are common and can be discouraging, but a flare is not deterioration — planning for them is part of good management.