12 Science-backed Ways to Recover From Fibromyalgia

Medical Disclaimer: The information in this article is provided for general informational and educational purposes only, and is not a substitute for professional medical advice.

Fibromyalgia is a painful, often debilitating condition with many symptoms. The causes of the condition can seem mysterious, so determining a successful treatment approach can be daunting.

Fibromyalgia involves an ongoing cycle of chronic pain, psychological stress, lack of sleep, inflammation, and sensitization of the nervous system. Recent research has found evidence of neuroinflammation and small-fiber neuropathy in fibromyalgia patients as well; this means that there is likely an autoimmune component to the condition.

In an autoimmune condition, the immune system mistakenly attacks our own healthy cells. Doctors and patients have long suspected an autoimmune component to fibromyalgia, because it resembles other autoimmune conditions in many ways. For example, they can be triggered by trauma and/or infection, and often occur along with other autoimmune conditions. But for many years, researchers were unable to find evidence of an autoimmune attack, such as physical damage, inflammation, and autoantibodies.

Research supporting an autoimmune aspect to fibromyalgia is now accumulating. A number of antibodies have been found to be higher in fibromyalgia patients than controls. These include antibodies to serotonin, smooth and striated muscle, moisture-producing glands (which occur in Sjögren’s syndrome), the thyroid gland (which occur in Hashimoto’s thyroiditis), and gangliosides (which are associated with small-fiber neuropathy).

A 2021 study demonstrated that the antibodies present in fibromyalgia patients cause painful hypersensitivity to cold and mechanical stimulation by sensitizing nociceptive (pain-sensing) nerve fibers. The researchers found that the antibodies target both brain cells and nerve fibers, showing how an autoimmune attack can cause the neurological symptoms present in fibromyalgia.

Another study published in 2021 identified a number of brain areas in which neuroinflammation was significantly higher in fibromyalgia patients than healthy controls. The areas of neuroinflammation correlated with higher levels of pain, stress, fatigue, and depression. It may be that neuroinflammation is the driving force behind the sensitization of the central nervous system that causes the heightened experience of pain in fibromyalgia.

The medical community isn’t yet in agreement about the exact mechanisms that cause fibromyalgia. But, there is a growing body of research demonstrating ways in which fibromyalgia patients reduce their symptoms and recover completely.

As you explore the healing practices below, be sure to keep in mind:

  • Different things work for different people, and change takes time. So, don’t worry if certain approaches don’t result in immediate improvements.

  • Try just one new practice at a time so you can be sure of how it’s affecting you. And, overloading your nervous system and immune system with too many new things at once can result in increased pain and other symptoms, simply because your body is not adapted to them.

  • Start each new practice by “microdosing” it first so your body can gradually adapt. For example, start with 5-10 minute workouts instead of longer sessions which may exacerbate your symptoms.

  • Track your progress by jotting down notes on your pain levels, other symptoms, and the healing activities you engaged in. This will allow you to see how each practice affects you over time.

Please click the “+” signs or links below to read short articles on how each approach reduces fibromyalgia symptoms.

Research consistently finds that circadian rhythms are disrupted or abnormal in fibromyalgia patients. People with fibromyalgia have difficulty sleeping at night due to pain, and as a result they feel tired during the daytime. Sleep disturbances that are initially caused by pain may trigger a downward cycle in which circadian rhythms continue to become more disrupted as time goes on. Fatigue during the day affects activity levels, which often are reduced or shifted to later in the day. Researchers have found that patients with the most abnormal circadian rhythms also report the highest levels of fatigue, pain, physical disability, and mood disorders.

Our circadian rhythms regulate levels of serotonin, melatonin, and cortisol, and levels of these substances are typically low or abnormal in fibromyalgia patients. Melatonin is a hormone that our pineal gland produces in response to darkness. In the evening, our melatonin levels naturally start to rise, letting our brain know that it’s time to go to sleep. Unfortunately, low levels of melatonin at night in fibromyalgia patients and higher than normal levels during the day contribute to disrupted sleep during the night, fatigue during the day, and even heightened pain perception.

Studies show that giving daily melatonin supplements to fibromyalgia patients reliably leads to a reduction in pain and fatigue, and an improvement in sleep quality, mood, and quality of life. Melatonin also functions as an anti-inflammatory and antioxidant. Research shows that low levels of melatonin can contribute to chronic inflammation, oxidative stress, and increased neuropathic and chronic pain in fibromyalgia patients.

Serotonin is a neurotransmitter that helps to regulate many functions of the body, including pain sensation, mood, cognition, memory, sensorimotor function, and sleep. Serotonin plays an important role in pain perception: it regulates pain information being sent from the peripheral nerves to the brain, helps to inhibit pain via descending pathways, and helps to modulate our psychological perception of pain.

Fibromyalgia patients have significantly low levels of serotonin as compared to healthy controls. And research shows that among fibromyalgia patients, lower levels of serotonin correlate with worse symptoms. Predictably, studies show that serotonin supplementation can improve symptoms including pain, depression, anxiety, and insomnia.

Even though supplementation of melatonin and serotonin has positive results for fibromyalgia patients, our brain and body do adapt to these supplements over time. The most effective way to improve levels of these substances is by exposing our eyes to bright light, which naturally stimulates serotonin production through the retino-raphe tract.

Serotonin is a precursor to melatonin, and thus we need adequate levels of serotonin in order to produce adequate levels of melatonin. Research demonstrates that bright light exposure during the daytime leads to increased levels of nighttime melatonin production and improvements in circadian rhythms. Fibromyalgia patients who get one hour of bright light exposure per day report significant improvements in pain sensitivity and overall function. Other research has demonstrated that the light exposure can be either bright or dim; both types of light exposure led to significant improvements in pain intensity, physical function, depression, and sleep disturbances when compared to controls.

How to take action: Getting bright light exposure from the sun is one of the easiest and most effective things you can do for your health—and you can start doing it today! For best results, aim for a minimum of one hour of outdoor light exposure sometime during the morning. Don’t wear sunglasses, but of course, don’t look directly at the sun either. You simply need to be outside with your eyes open. This is effective even on cloudy days.

In addition, be sure to practice healthy sleep habits:

  • Go to bed and wake up at the same time every day, even on weekends.
  • Reduce or avoid blue light exposure (TV and phone) right before bed and in the middle of the night; blue light reduces melatonin production.
  • Stop consuming all calories 2-3 hours before bedtime.
  • Avoid stimulants, added sugar, and alcohol.
  • Make your bed an inviting place that you want to go at night!

There are often many factors that contribute to developing fibromyalgia, but one of the most commonly agreed upon factors is stress. The onset of fibromyalgia can sometimes be attributed to a specific stressful incident, such as an injury, surgery, car accident, or physical attack. In these cases, the combination of physical pain and emotional stress surrounding the incident can trigger a cycle of pain and stress that leads to fibromyalgia. Fibromyalgia can also develop gradually, as a response to chronic stress or ongoing emotional trauma.

When we perceive stress, a series of hormones released in the brain triggers the adrenal gland to secrete hormones called glucocorticoids. These hormones are helpful during short-term stress, but in long-term stress they cause nothing but problems.

A part of the brain called the amygdala, along with the hippocampus and the rest of the limbic system, helps process emotional reactions and memories. Prolonged high levels of glucocorticoids enhance amygdala function, stimulating neuron growth and making synapses more active and sensitive. Some pain pathways pass through the amygdala, which helps create our emotional reaction to pain. When the amygdala is overactive, our reactions to pain are intensified, making our pain feel worse than it actually is.

Prolonged high levels of glucocorticoids also cause chronic inflammation, both in the brain and peripherally. This is why stress is the common risk factor in 75%-90% of chronic lifestyle-related diseases, including cancer, neurodegenerative diseases, cardiovascular diseases, and metabolic diseases.

Research clearly shows the pathway by which stress contributes to fibromyalgia symptoms. And when patients are interviewed about the cause of their fibromyalgia flares, stress is the most commonly reported factor.

A study of women who had recovered from fibromyalgia found that stress reduction played a central role in their recovery. The study authors write: “Instead of adapting their activities to pain, they used pain as a warning signal of too much stress in life. This significantly developed their ability to alter their life goals and everyday obligations.”

Researchers have studied a wide range of stress-reducing modalities with fibromyalgia patients, including cognitive behavior therapy (CBT), progressive muscle relaxation, autogenic training, guided imagery, meditation, and heart rate variability (HRV) biofeedback. Some studies show promising improvements in ability to control pain and overall functioning, along with a reduction in pain intensity, emotional distress, and depressive symptoms.

How to take action: If the idea of figuring out how to reduce your stress feels daunting, it can be very helpful to engage in talk therapy with a qualified professional. They can guide you through a process of identifying sources of stress and making changes in your lifestyle. They can also help you learn how to process past trauma, and give you tools to help cope with current sources of stress. In addition, many of the other approaches listed in this article—like exercise, reduction of muscle tension, and improving circadian rhythms—are very effective for reducing stress.

According to a 2023 review, exercise is the most commonly recommended treatment for fibromyalgia because research consistently shows how effective it is for reducing pain and fatigue in fibromyalgia patients. But movement can make fibromyalgia pain worse, and exercise can lead to post-exertional malaise. So, it can be daunting for someone with fibromyalgia to figure out how to build exercise into their lifestyle without experiencing negative side effects at first.

There are at least four reasons why exercise can improve fibromyalgia symptoms:

  • Exercise stimulates the release of endorphins, one of our endogenous opioids. These natural pain relievers reduce pain and stress and improve mood. Exercise also stimulates the release of endocannabinoids, which contribute to the feeling of euphoria we feel during and after exercise.

  • Exercise helps to balance levels of the neurotransmitters dopamine, noradrenaline, and serotonin. This regulation improves mood and reduces stress, thereby lessening our experience of pain.

  • Exercise mobilizes immune system cells known as T-cells, which reduce inflammation.

  • Exercise normalizes abnormal patterns of functional brain connectivity present in fibromyalgia patients.

A 2020 study of women with fibromyalgia found that a low-intensity exercise program that combined endurance training and coordination led to significant improvements in all measured symptoms: pain catastrophizing, anxiety, depression, stress, pain perception, and quality of life. A number of systematic reviews and meta-analyses, like these published in 2017, 2022, and 2023, show similar and consistent results in the published literature. Overall, while aerobic exercise may have slightly more benefit for reducing symptoms than resistance training, the difference is not significant. Research suggests that combining the two types of exercise may be the most effective approach for symptom reduction.

How to take action: If you have fibromyalgia and you want to start exercising, the most important thing to remember is to take it slow. You can start experiencing the benefits of exercise with just 5-15 minutes per day, and there is no benefit to overdoing it. Listen to your body: Don’t do anything that increases your pain, and take breaks to rest, even when doing a short workout.

In the beginning, stick to gentle exercises that don’t strain your body or raise your heart rate too high—you should be able to carry on a conversation while doing your workout. Track your workouts and your symptoms over the following days to see what helps and what doesn’t. And be sure to do workouts that you enjoy and look forward to—working out should be fun, and not stressful. You may enjoy reading this article in Healthline.

Muscle tension on its own can be painful, causing soreness and pulling joints out of alignment. In fibromyalgia patients, research shows that cognitive stress is associated with higher levels of muscle tension while at rest and increased pain intensity. Thus, muscle tension can be part of a vicious cycle in fibromyalgia: stress causes muscles to tighten, the tight muscles become painful and contribute to joint pain, which then causes more stress and more muscle tension to build up.

One approach that many people use to reduce muscle tension is massage therapy. A 2014 meta-analysis found that massage therapy received regularly for five weeks or longer led to significantly reduced levels of pain, anxiety, and depression in fibromyalgia patients. The researchers suggest several reasons why massage therapy can reduce fibromyalgia symptoms:

  • Massage temporarily reduces muscle tension and makes connective tissues more flexible.
  • Massage can improve blood and lymph circulation, allowing inflammatory and nociceptive (pain-causing) substances to be reabsorbed.
  • Massage therapy can regulate levels of serotonin, thereby improving mood and reducing pain.

Another approach to reducing muscle tension is progressive muscle relaxation (PMR), a technique which involves tightening and relaxing muscle groups throughout the body, one at a time and typically in a specific order. For fibromyalgia patients, PMR can be effective for relieving anxiety and reducing the associated muscle tension. PMR also helps fibromyalgia patients develop awareness of which muscles they tend to unknowingly hold tight.

Another tool that fibromyalgia patients can use to improve awareness of their muscle tension is electromyograph (EMG) biofeedback. EMG biofeedback uses sensors to measure the level of activity, or tension, within muscles. This technique helps users become aware of when they’re holding excess tension in their muscles, and allows them to attempt to voluntarily relax their muscles at will. Controlled trials and small pilot studies have had generally positive results, suggesting that EMG biofeedback may be a promising treatment for fibromyalgia.

Voluntary pandiculation, as taught in Clinical Somatics, is also a highly effective way to reduce muscle tension and pain, calm the nervous system, and improve awareness of muscle tension. While formal research has not yet been done on the efficacy of voluntary pandiculation specifically for fibromyalgia patients, some people—including Steven Aronstein and Edward Barrera—have used the technique to completely recover from fibromyalgia. Voluntary pandiculation reduces muscle tension by resetting gamma loop activity. This leads to a lasting reduction in muscle tension and pain and a reduction in associated psychological stress. Clinical Somatics also gives fibromyalgia sufferers a slow, gentle way to move their body when more vigorous forms of movement are too painful or tiring.

How to take action: Using these various techniques to reduce muscle tension is worthwhile for all fibromyalgia sufferers. But just like with exercise, you should start slow. Even beneficial practices or treatments can result in discomfort, soreness, or fatigue afterward simply because they are new and your nervous system isn’t accustomed to them. So if you get a massage, make sure it’s a very gentle massage, and start with 15-30 minutes rather than a full hour. If you learn Clinical Somatics exercises, start with very short practices of 5-10 minutes, do just one or two repetitions of each exercise at first, and consider practicing them as micromovements.

The gut microbiome, also called the gut microbiota or gut flora, is the collection of bacteria, fungi, and viruses that live in our digestive tract. Our gut microbiome protects us from pathogens that enter through our gut, maintains our gut lining, and metabolizes food. It also affects our systemic immunity and our behavior through the gut-brain axis.

In 2019, the first study to directly link gut microbiome health to fibromyalgia was published. The study found significantly different levels of 19 species of gut bacteria in fibromyalgia patients as compared to controls. Some levels were abnormally high, while others were abnormally low. The degree of abnormalities in the microbiome was directly related to the severity of symptoms, including pain intensity, cognitive dysfunction, and fatigue. The microbiome composition of the fibromyalgia patients was so distinct from controls that it could be used to predict which study subjects had fibromyalgia and which did not. This means that gut microbiome testing could potentially be used as a diagnostic tool for fibromyalgia.

Netflix recently made research about the gut microbiome mainstream in the popular new documentary Hack Your Health. The film emphasizes that the health of our gut microbiome is directly related to the diversity of our diet, in particular to the variety of plant foods we eat. A famous study published in 2018 found that people who eat more than 30 different types of plant foods each week have significantly more diverse microbiomes than people who eat 10 or fewer types of plant foods each week.

Eating a variety of different plant foods is important because the fiber in plant foods feeds the microbes that make up our gut microbiome. They need plentiful, diverse sources of fiber in order to survive, and when we don’t give them enough fiber, they start eating the protective layer of mucus that lines the inside of our intestines. This mucus layer absorbs water and nutrients, and it also prevents infectious bacteria and other pathogens from getting into our bloodstream. When the beneficial microbes in our gut start eating away at the protective mucus layer, we develop intestinal permeability or “leaky gut syndrome.” In this condition, toxic molecules are able to pass from the gut into the bloodstream, potentially triggering an inflammatory response and contributing to chronic health conditions such as autoimmune diseases.

A treatment approach featured in Hack Your Health that probably caught many viewers by surprise is fecal matter transplant (FMT). People who suffer from severe imbalances in their gut microbiome and are unable to improve their symptoms through dietary changes may consider this option. It involves taking fecal matter donated by a thoroughly-screened, healthy individual and transferring it to the colon of the recipient.

FMT is most commonly used to treat C. difficile infections, but is now being researched as a potential treatment for other conditions including irritable bowel syndrome, inflammatory bowel diseases, insulin resistance, multiple sclerosis, idiopathic thrombocytopenic purpura, fibromyalgia, and chronic fatigue syndrome. A 2024 study found that after six months of FMT treatment, there was a significant increase in serotonin and gamma-aminobutyric acid (GABA) levels in the fibromyalgia patients. The researchers state that “FMT can effectively improve the clinical symptoms of fibromyalgia.” And a 2019 study found that FMT was effective for reducing the symptoms of chronic fatigue syndrome when it co-occurs with irritable bowel syndrome.

How to take action:

  • You can ask your doctor to order a microbiome test for you, which requires a stool sample.

  • You can keep track of how many different plant foods you eat on a regular basis using a chart like this. If you’re sensitive to new foods and fiber intake in general, take the approach of “microdosing:” introduce new foods in very small servings, and gradually increase serving size as you are able to comfortably.

  • You can learn some of the basics about fecal transplants in this article from VeryWellHealth. If you’re interested in pursuing this option, be sure to consult with a knowledgeable health professional; FMT should not be attempted on your own at home.

Research clearly shows that dietary changes can be very helpful for some people with fibromyalgia. But there isn’t one specific diet that has been proven to be the best for everyone with fibromyalgia, because everyone’s guts and immune systems are unique. We all have different foods that trigger inflammation for us. So it’s important to take the time to explore dietary changes, and as I’ll mention at the end of this section, do an elimination diet for a period of time.

A 2021 review found that people with fibromyalgia who follow a mostly plant-based diet experience improvements in biochemical markers, quality of life, quality of sleep, and pain intensity. The reasons why a plant-based diet can be helpful are the increase in antioxidants, micronutrients, and fiber, which as I discussed in the previous section helps to improve microbiome health. Plant-based diets are often much lower in fast food, processed food, and added sugar, all of which increase inflammation. So, plant-based diets are likely beneficial because of the increase in whole plant foods and reduction of low-quality foods, and not necessarily because of the reduction or elimination of animal products.

On the flip side, plant foods may cause inflammatory reactions in some people. Plant foods contain various allergens which can cause or exacerbate inflammatory health conditions. For this reason, some people with fibromyalgia and other inflammatory conditions report feeling great when they adopt a “carnivore diet” in which they eat predominantly whole, unprocessed animal products. This is because they’ve eliminated the plant foods that could be triggering their inflammation, and because this type of diet typically reduces or eliminates processed food and added sugar.

The danger in following a carnivore diet long-term is the vast reduction of fiber intake. As discussed in the previous section, our gut microbiome needs fiber in order to survive and keep us healthy. So, a carnivore diet could be used short-term as a type of elimination diet, but it is likely not the best long-term solution for most people.

One plant-food allergen that consistently comes up in fibromyalgia research is gluten, which is a type of lectin. Lectins are proteins that plants produce as a self-defense system, so that predators like us won’t eat them. In our digestive system, lectins can prevent absorption of nutrients, damage the walls of our intestines, and contribute to autoimmune conditions.

A study of 20 fibromyalgia patients found that after following a gluten-free diet for 16 months, their level of chronic pain improved dramatically. Fifteen of the patients experienced complete elimination of pain, which indicated remission of fibromyalgia. Other symptoms including fatigue, gastrointestinal symptoms, migraine, and depression also improved. Another study of 97 people who had both fibromyalgia and irritable bowel syndrome found that following a gluten-free diet for one year resulted in significant improvement in all symptoms.

The ultimate type of elimination diet is, of course, fasting. Therapeutic fasting has become quite popular due to its immediate positive effect on regulating blood sugar and insulin levels, allowing for the burning of body fat through ketosis, and temporary relief from gut-related issues. And research clearly shows how both fasting and caloric restriction reduce inflammation, reduce pain, and enhance mood. Both fibromyalgia and rheumatoid arthritis patients report that skipping meals and/or doing elimination diets alleviate their symptoms.

For people with fibromyalgia, going without food for a period of time may be helpful in the following ways:

  • Fasting immediately eliminates all foods that may be triggering inflammation.
  • Fasting induces the state of autophagy, by which the body gets rid of old, damaged cells and replaces them with new, healthy cells. Autophagy regenerates the immune system and can clear bacteria and viruses from the body.
  • Fasting triggers the release of adrenaline, which boosts energy.
  • Fasting may allow bad gut bacteria to die off.
  • Fasting increases serotonin levels, which are typically low in fibromyalgia sufferers.

How to take action: You can start with an elimination diet, in which you completely eliminate potentially inflammatory foods from your diet for a period of time, ideally at least one month. If you want guidance, a great place to start is with the Whole30 diet. After eliminating all possible triggers of inflammation, you’ll go through a process of reintroducing foods one at a time. This allows you to isolate the effects of individual foods, which can be very difficult to discern when consuming a typical, varied diet.

If you consider fasting, get approval from your doctor and read Dr. Jason Fung’s The Complete Guide to Fasting. It’s very important to practice fasting safely and moderately. Be sure to balance out your fasting with consumption of whole, nutritious foods during your eating windows, and refeed slowly and intentionally after extended fasts in order to improve the health of your gut microbiome.

People with fibromyalgia tend to be deficient in certain micronutrients, including but not limited to magnesium, selenium, and vitamins B and D. Researchers propose that certain nutrient deficiencies are linked to dysfunction of pain inhibitory mechanisms, resulting in an increase in the experience of pain. Nutrient deficiencies may also be related to other fibromyalgia symptoms, such as fatigue. Experts report that “when optimal levels of nutrition are achieved, pain levels are usually lowered.”

Since magnesium takes part in over 300 enzymatic reactions in the body, deficiency can lead to a wide range of health problems and symptoms. Many of these symptoms are present in fibromyalgia, including muscle tension, chronic pain, migraines, mood disorders, a weakened immune system, fatigue, and sleep problems. Magnesium deficiency co-occurs with chronic low-grade systemic inflammation, raising levels of pro-inflammatory cytokines and C-reactive protein. It may also increase levels of substance P, a neuropeptide that can increase sensitivity to pain. In addition, research shows that chronic sleep deprivation can lead to magnesium deficiency. So there may be a vicious cycle occurring in which symptoms of fibromyalgia prevent sufferers from sleeping at night, which then leads to lower levels of intracellular magnesium, which worsens symptoms even more. A 2022 study found that taking 100mg of magnesium chloride daily for one month led to a reduction of stress and pain in fibromyalgia patients. You can learn more about magnesium and ways to supplement in this article.

Selenium deficiency may contribute to the musculoskeletal pain, weakness, and fatigue experienced in fibromyalgia. Long-term selenium deficiency also weakens the immune system, making it harder to fight off pathogens and allowing inflammation to become chronic. In addition, selenium helps to regulate neurotransmission, synchronize neural activity, facilitate the dopamine pathway, and provide neuroprotection. Low selenium levels can contribute to hyperalgesia, which describes a condition of the nervous system in which the experience of pain is amplified. A 2017 study found that selenium supplementation in fibromyalgia-induced rats led to reduced pain intensity and reduced levels of reactive oxygen species, which cause molecular and cellular damage throughout the body. Researchers state that “selenium supplementation in deficient FM patients can improve clinical symptoms and benefit the quality of life.”

B vitamins have a direct impact on energy level, brain function, and cell metabolism. They play important roles in cellular health, growth of red blood cells, brain function, nerve function, and muscle tone. Deficiency in B vitamins can contribute to fatigue, weakness, confusion, irritability, and depression. A 2015 study found that patients with fibromyalgia and chronic fatigue syndrome benefited from B12 injections along with oral folic acid (synthetic B9) supplementation. The fibromyalgia patients who reported the most significant improvement were the ones who had significantly more frequent B12 injections and higher daily amounts of folic acid.

Vitamin D is very important for fibromyalgia sufferers, as it facilitates normal immune system function, regulates inflammation, supports brain cell activity, regulates muscle contraction, and helps to convert blood sugar into energy. Symptoms of vitamin D deficiency include fatigue, poor sleep, muscle weakness, pain, stress, anxiety, and depression. A study published in 2018 tested the effects of high doses of vitamin D (50,000 IU once a week for three months) on fibromyalgia symptoms. After three months, 72% of participants reported a very significant improvement in symptoms, including a reduction in the number of tender points. And a 2012 study found that fibromyalgia patients with lower levels of vitamin D were more likely to have short-term memory impairment, confusion, mood disturbance, sleep disturbance, restless leg syndrome, and palpitations. Vitamin D can be obtained through whole foods, fortified foods, and supplements, but the best way to get enough of this essential nutrient is to expose your skin to the sun. Our skin produces its own vitamin D when it’s exposed to the UV-B rays of the sun without the protection of sunscreen. It’s recommended that you limit this type of exposure to approximately 15 minutes at a time in order to avoid sunburn, depending on your skin type and latitude where you live. An excellent book on this topic is The Healing Power of the Sun by Richard Hobday.

How to take action: You can ask your healthcare provider to order a comprehensive micronutrient test, which measures your deficiencies and your body’s ability to utilize a range of important vitamins, minerals, and essential nutrients. If you are not able to get this test done through your healthcare provider, you can have it done through an independent lab such as Spectracell, AnyLabTestNow, or LetsGetChecked. Please note that these are just examples; if you choose to purchase your own test through an independent lab, be sure to do your own research and find the right test and lab for you.

Some experts believe that at least one chronic bacterial, viral, fungal, or parasitic infection is present in nearly all autoimmune conditions. These infections can trigger the onset of symptoms, or can surface when the immune system becomes weak. Some of the infections most commonly linked to fibromyalgia include Lyme disease, mycoplasma, human herpesvirus 6, Epstein Barr virus, hepatitis C, and cytomegalovirus.

Fibromyalgia and Lyme disease have some similar symptoms, like fatigue, headache, short-term memory loss, body aches, sleep disturbances, and mood changes. So, some people with Lyme disease are initially diagnosed with fibromyalgia. This can occur because testing for Lyme disease is notoriously unreliable, producing many false-negative results.

Research shows that between 8% and 10% of Lyme patients also develop fibromyalgia symptoms during the course of their disease process. The limited published research on this topic shows that for these patients, antibiotics are effective for resolving Lyme disease but not for resolving the related fibromyalgia symptoms, and the reason why is unclear. However, it should be noted that both chronic Lyme disease and fibromyalgia are not well understood by the medical community. If you suspect you have Lyme disease, you can start by using this symptom checker provided by LymeDisease.org.

Mycoplasma is the smallest self-replicating species of bacteria that infects the human body. Due to its small size and ability to alter its shape, it can invade areas of the body that are otherwise only infected by viruses. While acute mycoplasma infections are easy to diagnose, chronic mycoplasma infections tend to be more difficult to diagnose. Symptoms of mycoplasma infection include chronic fatigue, headaches, and muscle and joint pain. Eight-two percent of people with Lyme disease also test positive for mycoplasma infections. A 2003 review found that approximately 50% of patients with chronic fatigue syndrome (CFS) and/or fibromyalgia have mycoplasma infections, compared to just 10% of healthy control subjects. The review reported that most patients are able to recover and regain full health after long-term antibiotic therapy with doxycycline.

There is far more published research on the connection between chronic infections and chronic fatigue syndrome than fibromyalgia. This may indicate that there is a stronger connection between CFS and chronic infections, or simply that not enough research on the connection between chronic infections and fibromyalgia has been done yet.

One thing we do know is that levels of IgG antibodies are higher in fibromyalgia patients than in control subjects. IgG antibodies are one type of immunoglobulins produced by our immune system. IgG antibodies “remember” which germs we’ve been infected by before, so that if we get infected by the same germs again, our immune system knows how to attack them. A 2023 study found that not only are levels of IgG antibodies higher in fibromyalgia patients than controls, but also that levels of IgG antibodies are associated with pain. Patients in the the severe fibromyalgia group had higher levels of antibodies than those in the mild fibromyalgia group. A previous study published in 2021 found that IgG antibodies from fibromyalgia patients sensitize nociceptive (pain-sensing) neurons, producing sensory hypersensitivity to pain and cold stimulation.

How to take action: If you suspect you may have a chronic infection, I highly recommend reading the book Chronic by Dr. Steven Phillips and Dana Parish. If you want to get tested, be sure to seek out a medical professional who specializes in diagnosing and treating long-term infections, as many medical professionals are not well-versed in this area. And while antibiotic or antimicrobial treatment may reduce or eliminate symptoms entirely, it’s also important to keep your immune system as strong as possible with diet, nutrition, exercise, stress reduction, and improving your circadian rhythms.

Fibromyalgia patients are often highly sensitive to toxins, such as heavy metals, mold, and chemicals such as pesticides. It may also be the case that the natural detoxification pathways in fibromyalgia patients may not be working effectively, leading to a buildup of these toxins within their body. It is important to find out if metals and other toxins are a factor in your illness, because they can cause inflammation and interfere with your body’s ability to absorb and use essential nutrients.

A study published in 2013 tested the effects of removing metal exposure from fibromyalgia patients. Initially, all fibromyalgia patients tested positive for being allergic to at least one type of metal, while most of the healthy controls tested negative. Metal dental fillings were removed from the fibromyalgia patients, and they committed to avoiding known sources of metal exposure. Five years later, half of the fibromyalgia patients no longer met the criteria for fibromyalgia, and another 20% had improved, while just 30% still had fibromyalgia. However, all patients reported health improvements, which correlated with normalization of metal allergy tests.

Molds produce mycotoxins, which are more likely to lead to fungal infection in individuals with a weakened immune system than in those with a healthy immune system. One study found that 93% of chronic fatigue syndrome patients tested positive for at least one mycotoxin in their urine. Mycotoxins can cause inflammation in the gut, necrosis, and damage to the protective walls of the intestines. Mycotoxin infection can also have neurotoxic effects and has been linked to pain, movement difficulty, dementia, balance and coordination disorders, and systemic neuronal degeneration. While definitive research is lacking, it is widely suspected that mycotoxin infection plays a role in fibromyalgia for some patients.

A 2021 paper put forth a new explanation for the increasing incidence of chemical sensitivity in the U.S. population. The authors have named the condition Toxicant-Induced Loss of Tolerance (TILT). When we’re exposed to chemicals such as pesticides or volatile organic compounds (VOCs), our immune system activates mast cells. These cells are the first responders to toxic foreign substances. Repeated exposure or a single instance of high exposure can lead the immune system to become highly sensitive to these toxins. After the immune system becomes oversensitive, or less tolerant, “even low levels of these and other unrelated chemicals can cause the mast cells to release hundreds of inflammatory chemicals.” The authors state that TILT provides an explanation for a new category of environmentally induced conditions, including fibromyalgia and chronic fatigue syndrome.

How to take action: If you are concerned about your exposure to heavy metals or mold, you can ask your doctor for a heavy metal blood test and/or a mycotoxin test. You can remove sources of metal exposure, which may include dental fillings, certain foods, tap water, certain medications and supplements, or working with heavy metals at your job. You can look for mold in your home, which can be caused by leaks in pipes, leaks in the roof or foundation, poor ventilation, high humidity, condensation, flooding, and HVAC systems.

There is currently no blood or lab test that can be used to diagnose chemical sensitivities. Diagnoses are made based on reported symptoms that appear during exposure to certain chemicals and go away after the chemicals have been removed. You can discuss possible sensitivities with your doctor, and you can take steps to reduce your exposure to substances such as pesticides, household cleaning products, beauty products, and industrial chemicals.

Cryotherapy describes cooling a part of the body or the entire body for therapeutic purposes. Traditionally, cryotherapy has been practiced by using ice packs and cold-water immersion baths. Whole-body cryotherapy (WBC) is now being extensively researched as natural therapy for a wide variety of health conditions, including fibromyalgia. Whole-body cryotherapy is typically carried out in a chamber in which the user stands up for two to three minutes. Very dry, cold air circulates in the chamber, lowering skin temperature in a comfortable way.

Whole-body cryotherapy has proven to be a safe and effective treatment for pain conditions such as fibromyalgia that involve central sensitization. Reasons for this include the fact that WBC reduces inflammation, has positive effects on cytokines and hormones, regulates the autonomic nervous system, and releases neurotransmitters that modulate pain sensation and mood. For fibromyalgia sufferers, this translates into a decrease in pain, improvement in mood, strengthening of the immune system, and improvement in the quality of life.

A 2021 study tested the effects of once-weekly WBC sessions in fibromyalgia patients. WBC resulted in a significant reduction in pain and disease activity after three weekly sessions and six weekly sessions. The researchers suggested that symptom improvement may be explained by altered levels of cytokines (proteins involved in immune cell signaling), which were measured throughout the study. Three months after WBC treatment ended, no improvement could be measured; so, it seems that WBC must be continued on a regular basis in order for improvements to continue. However, other research has shown residual positive effects of WBC lasting for one month after treatment.

Another study tested the effects of 15 cryotherapy sessions on a group of 100 fibromyalgia patients. The patients reported a pronounced improvement in quality of life. Again, the researchers attributed the improvement to the regulation of inflammatory mediators, which play a role in pain perception.

Other research suggests that cryotherapy reduces fibromyalgia symptoms due to modulation of certain neurotransmitters, including norepinephrine (noradrenaline) and dopamine. For these reasons, WBC is also being researched as a treatment for depression.

Research also shows the benefit of local cryotherapy for fibromyalgia sufferers. A 2017 study tested the effect of a 10-minute cold application on the painful upper trapezius muscles of 55 fibromyalgia patients. Their pain level was measured just before the cold application, and then 10 minutes, 90 minutes, and 24 hours later. Not only were the reported pain scores much lower after 10 minutes and 90 minutes, but the pain scores were still significantly lower after 24 hours.

How to take action: Cryotherapy is easy to start at home for free, and you may later decide to spend money on a more expensive version. At home, you can put ice packs or ice sleeves on specific painful areas of your body. You can also take cold showers, take a cold bath, or add ice to a cold bath. If you want to try the more expensive options, you can seek out a local spa that offers whole-body cryotherapy or a cold plunge tub. You may decide to continue with regular WBC sessions at a spa, purchase a cold plunge tub, or simply purchase a chiller for your bathtub. If you are highly sensitive to cold, you may find that WBC is more tolerable than a cold plunge tub.

Red light therapy, also referred to as low-level laser therapy (LLLT) and photobiomodulation, uses red and near-infrared light to stimulate biochemical changes in the cells of our body. Red and near-infrared light improve our production of ATP, which is our cells’ main source of energy. Absorption of red and near-infrared light also improves cell signaling, the synthesis of growth factors, and reduces oxidative stress. Thousands of studies on red light therapy have shown benefits for a wide range of health problems, from skin conditions to autoimmune disorders to neurodegenerative diseases.

Humans evolved being exposed to red and near-infrared light naturally. These wavelengths of light are present in the greatest amounts during the first 45 minutes after sunrise and the last 45 minutes before sunset. Since most of us are indoors during these times of day—or if we’re outdoors, we likely don’t have much of our skin exposed—we’re missing out on the natural, very necessary health benefits of red and near-infrared light. So, red light therapy simply replaces a type of light that we should be exposed to daily but aren’t anymore due to our modern-day lifestyles.

Red light therapy is beneficial for fibromyalgia sufferers for at least four reasons. It improves cellular energy, relieves pain, and reduces inflammation, including the neuroinflammation that plays a role in fibromyalgia. Red light therapy has even been shown to improve the health of the gut microbiome, which as I described in that section of this article, is directly linked to the immune system and severity of fibromyalgia symptoms.

A 2002 study of 40 fibromyalgia patients found that red light therapy is effective for reducing pain, muscle spasms, morning stiffness and total number of tender points. Notably, none of the participants reported any negative side effects. Likewise, a 2014 study of 20 fibromyalgia patients found significant improvements in all symptoms after 12 red light therapy treatments.

And a 2018 study of 160 fibromyalgia patients found that the combination of red light therapy with exercise was particularly effective for reducing tender point numbers, anxiety, depression, and fatigue, and for improving sleep and quality of life.

How to take action: I highly recommend reading Ari Whitten’s book Red Light Therapy, in which he discusses the science of red light therapy, the benefits for a wide range of health conditions, proper dosing, and how to choose the right equipment for home use. You may also be able to try out red light therapy at a local wellness center, like Restore Hyper Wellness.

Grounding, also called earthing, is the practice of bringing your body into contact with the natural electrical charge on the surface of the Earth. This is achieved by either putting bare skin on the surface of the Earth, or by using an indoor grounding device like a grounding mat. We evolved being in a grounded electrical state 24 hours per day, yet now most of us are ungrounded nearly all the time.

When bare skin touches the Earth or a grounding device, free electrons from the Earth’s surface travel into the body, where they pair with the excess free radicals that cause damaging chronic inflammation. Free radicals, more formally called reactive oxygen species (ROS), are produced constantly in the body. Under normal conditions, there is a balance between the natural creation and removal of free radicals from the body. However, lifestyle factors including stress and diet can cause excess free radicals to build up.

Excess free radicals contribute to oxidative stress, causing damage to our body at the cellular level, and contribute to many chronic diseases. A study published in 2023 found that fibromyalgia patients have significantly higher levels of free radicals and total oxidative stress, along with lower levels of antioxidants, than healthy control subjects.

By neutralizing free radicals, the free electrons from the Earth provide a natural antioxidant and anti-inflammatory effect, which can be seen on thermographic images. Grounding a person or animal leads to measurable changes in the number of white blood cells, cytokines, and various inflammatory substances present in chronic inflammation.

Grounding can sound a bit “out there” if you haven’t heard of it before, but a growing body of published research clearly demonstrates the powerful effect that grounding has on our physiology. Grounding has been shown to reduce pain, improve sleep, normalize circadian rhythms, reduce stress, stimulate the parasympathetic nervous system, improve vagal tone, speed wound healing, regulate blood sugar levels, and improve production of thyroid hormones.

While research testing the effects of grounding specifically for fibromyalgia patients has not been done yet, anecdotal evidence from fibromyalgia sufferers and healthcare providers suggests that it can be highly effective for reducing fibromyalgia pain. There are many studies showing the efficacy of grounding for reducing inflammation, pain, and stress, as well as for improving sleep—all of which are hallmark symptoms of fibromyalgia. And since being electrically grounded is the natural electrical state that we should be in, it makes sense for all of us to incorporate grounding into our lives.

How to learn more: If you want to learn more about the science of grounding and read stories of people who have reversed their chronic health conditions with grounding, I highly recommend Clint Ober’s book Earthing. When you start practicing grounding, I recommend starting with short 15-30 minute sessions outdoors, with bare feet on dirt or grass. If you want to ground yourself indoors, you can purchase grounding products from a reputable company like Earthing.com. Be sure to increase the amount of time you spend grounded very gradually, and test your outlets for proper grounding as instructed with the devices you purchase.

Recommended reading:

The Pain Relief Secret: How to Retrain Your Nervous System, Heal Your Body, and Overcome Chronic Pain by Sarah Warren, CSE

Somatics: Reawakening the Mind’s Control of Movement, Flexibility and Health by Thomas Hanna