If you wake up exhausted no matter how long you slept, ache in places that don’t seem connected, and struggle to remember simple things mid-conversation, you are not imagining it. Fibromyalgia is a real, biologically grounded condition, and it affects an estimated 4 million adults in the United States, about 2% of the adult population, according to the Centers for Disease Control and Prevention. Globally, prevalence estimates run as high as 2% to 8% of the population, and it is roughly twice as common in women as in men.
At Colorado Injury & Wellness, Dr. Austin Clarke works with patients throughout Colorado Springs who are dealing with the widespread pain, fatigue, and brain fog that come with fibromyalgia. This guide walks through what causes fibromyalgia, the most common symptoms of fibromyalgia, how it gets diagnosed, and what a chiropractor for fibromyalgia can realistically offer as part of a broader fibromyalgia treatment plan.
What Is Fibromyalgia?
Fibromyalgia is a long-term condition that causes widespread pain throughout the body, along with fatigue, sleep problems, memory issues, and mood changes. Researchers now understand that fibromyalgia affects the way the brain and spinal cord process painful and non-painful signals, which increases a person’s overall sensitivity to pain. This mechanism is called central sensitization, and it is considered the pathophysiological hallmark of the condition, according to Mayo Clinic.
In plain terms, the nervous system’s volume dial for pain gets turned up. A touch that would feel like normal pressure to someone else can register as genuinely painful for a person with fibromyalgia.
Symptoms often start after a triggering event such as an injury, surgery, infection, or a period of significant emotional stress. For other people, symptoms build up gradually over time with no single clear trigger. Fibromyalgia can affect people of any age, including children, but it is most commonly diagnosed in women between the ages of 20 and 55, with prevalence increasing with age.
Fibromyalgia frequently overlaps with other conditions, including irritable bowel syndrome, chronic fatigue syndrome, migraine and other headache disorders, restless legs syndrome, sleep apnea, and TMJ disorders.
Symptoms of Fibromyalgia
The symptoms of fibromyalgia vary from person to person, and severity can shift from day to day. The most commonly reported symptoms include:
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Widespread pain that affects both sides of the body and occurs above and below the waist, typically described as a constant dull ache
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Fatigue that persists even after a full night’s sleep
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Non-restorative sleep and other sleep disturbances, including insomnia and restless legs syndrome
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Fibro fog, a form of cognitive dysfunction that includes forgetfulness, trouble concentrating, and word-finding difficulty. More than half of people with fibromyalgia report some degree of memory or cognitive decline
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Stiffness, particularly in the morning
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Heightened sensitivity to cold temperatures, bright light, loud noise, and strong odors
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Digestive symptoms, often overlapping with irritable bowel syndrome
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Mood changes, including anxiety and low mood
Because fibromyalgia shares symptoms with several other conditions, including arthritis, it is often misdiagnosed or takes years to properly identify. If you are unsure whether your joint pain points to fibromyalgia or something else, our post on how a chiropractor evaluates for arthritis walks through how the two can be told apart. If several of these symptoms sound familiar and have lasted three months or longer, it is worth having a conversation with a healthcare provider.
What Causes Fibromyalgia? 10 Root Causes
There is no single answer to what causes fibromyalgia. Researchers now describe it as a multifactorial condition, meaning it typically develops from a combination of genetic vulnerability, nervous system changes, and one or more environmental triggers working together. Here are the ten factors most consistently connected to fibromyalgia causes in current research.
1. Genetic Predisposition
Fibromyalgia tends to run in families, and the genetic evidence behind this has grown substantially. A large multi-ancestry genetic study published in Nature Medicine in 2026, involving more than 2.5 million individuals, identified 26 genetic risk loci associated with fibromyalgia and found strong genetic overlap with low back pain, irritable bowel syndrome, and post-traumatic stress disorder. Researchers involved in the study noted that the findings point to a neurological origin for the disorder and suggested that even people carrying multiple fibromyalgia-linked genetic variants likely need an additional trigger, such as an injury or infection, before symptoms appear.
2. Central Nervous System Dysfunction
Central sensitization, the abnormal amplification of pain signals in the brain and spinal cord, is considered the core mechanism behind fibromyalgia. Brain imaging studies have shown that people with fibromyalgia process pain differently than people without the condition, experiencing both increased pain from things that should hurt (hyperalgesia) and pain from things that normally would not hurt at all (allodynia).
3. Physical Trauma or Injury
A systematic review of 51 studies examining triggers for fibromyalgia found that a majority of the studies described a significant association between a prior physical injury and the onset of chronic widespread pain or fibromyalgia. This includes injuries from accidents, surgery, and other physically traumatic events. If you have been in a car accident and are wondering how soon to get checked out, our guide on how long after a car accident you should see a chiropractor covers that timeline in more detail. This is one of the reasons a chiropractor for fibromyalgia is often part of a care team, since many patients trace their symptoms back to a specific physical injury.
4. Emotional Trauma and Chronic Stress
The same 51-study review found elevated rates of psychological trauma among fibromyalgia patients, with several studies pointing to a mediating role for post-traumatic stress disorder. In one study of 88 women diagnosed with fibromyalgia, 71.5% met the criteria for current PTSD, and 84% reported a traumatic event occurring before their pain began. Researchers believe that chronic emotional stress can sensitize the nervous system in ways similar to physical trauma.
5. Infections
Several viral and bacterial infections have been linked to the onset of fibromyalgia, including Epstein-Barr virus, cytomegalovirus, human herpesvirus 6 and 7, hepatitis B and C, HIV, Lyme disease (Borrelia burgdorferi), and H. pylori. Researchers believe that the immune and nervous system strain caused by fighting off a serious infection can, in some people, leave the nervous system stuck in a heightened, sensitized state even after the infection clears. A Norwegian study found that fibromyalgia, like long COVID and chronic fatigue syndrome, can be a post-infectious condition.
6. Sleep Disorders
Non-restorative sleep is so closely tied to fibromyalgia that it is built into the current diagnostic criteria. More than 90% of people with fibromyalgia report disturbed, unrefreshing sleep. Sleep studies show that people with fibromyalgia spend less time in deep, slow-wave sleep and experience frequent bursts of awake-like brain activity during the night, which limits the body’s ability to repair itself. Poor sleep and fibromyalgia symptoms tend to feed into each other, with each one making the other worse.
7. Hormonal Imbalances
Several studies have examined the hypothalamic-pituitary-adrenal (HPA) axis, which regulates the body’s stress hormone response, in people with fibromyalgia. Findings have been mixed. Some studies show abnormally flattened cortisol rhythms or elevated evening cortisol, while others show lower overall cortisol levels compared to healthy individuals. What researchers generally agree on is that the HPA axis does not function normally in many fibromyalgia patients, and this dysregulation may affect pain processing, sleep, and fatigue.
8. Autoimmune and Inflammatory Involvement
This is one of the more debated areas of fibromyalgia research. In 2021, researchers from King’s College London, the University of Liverpool, and the Karolinska Institute published a study in the Journal of Clinical Investigation showing that when antibodies from fibromyalgia patients were injected into mice, the mice developed fibromyalgia-like symptoms, including increased pain sensitivity, muscle weakness, and reduced nerve fiber density. The mice recovered once the antibodies cleared their systems. The researchers suggested this pointed to fibromyalgia being, at least in some cases, a disease of the immune system.
Other prominent pain researchers, including Dr. Daniel Clauw of the University of Michigan, have expressed skepticism that this single study proves fibromyalgia is broadly autoimmune, noting it is difficult to explain symptoms like light and odor sensitivity through this mechanism alone. Since then, researchers have continued studying antibody involvement, and it remains an active area of investigation rather than settled science.
9. Gut Microbiome Imbalances
A growing body of research has found that people with fibromyalgia tend to have less diverse gut bacteria and altered levels of short-chain fatty acids compared to people without the condition. This has led researchers to investigate the gut-brain axis as a possible contributor to central sensitization. A systematic review found that this evidence is still building, with low to moderate certainty overall, but the associations between gut dysbiosis and fibromyalgia symptoms like pain, fatigue, and cognitive dysfunction were consistent enough to warrant continued research.
10. Nutrient Deficiencies
Studies have found that approximately 40% of fibromyalgia patients are deficient in vitamin D, and low vitamin D levels have been associated with more chronic pain, depression, and anxiety in this population. Magnesium deficiency has also been linked to increased pain sensitivity and stiffness. A 2024 study confirmed that lower vitamin D and magnesium levels were associated with worse physical function and stiffness in fibromyalgia patients, though researchers note that supplementation studies so far have been small and results are not yet conclusive enough to call nutrient deficiency a primary cause on its own.
How is Fibromyalgia Diagnosed?
There is no blood test, imaging scan, or biopsy that can definitively diagnose fibromyalgia. Diagnosis is based on a combination of symptom history and a physical exam.
The current diagnostic standard is the 2016 revised American College of Rheumatology (ACR) criteria. A diagnosis requires:
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A Widespread Pain Index (WPI) score of 7 or higher and a Symptom Severity Scale (SSS) score of 5 or higher, or a WPI of 4 to 6 with an SSS of 9 or higher
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Generalized pain present in at least 4 of 5 body regions
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Symptoms present at a similar level for at least three months
Importantly, this newer criteria no longer requires ruling out every other possible condition before a fibromyalgia diagnosis can be made, which has helped shorten the diagnostic delay many patients previously experienced. That said, providers still typically run bloodwork and other tests to check for conditions with overlapping symptoms, such as rheumatoid arthritis, lupus, thyroid disorders, and vitamin D deficiency.
Fibromyalgia Treatment: What Actually Works
How to treat fibromyalgia effectively usually means combining more than one approach. No single treatment resolves fibromyalgia on its own, and the strongest outcomes tend to come from combining medical care, physical therapy or chiropractic care, and lifestyle changes.
Medications
As of 2025, four medications carry FDA approval specifically for fibromyalgia:
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Pregabalin (Lyrica), approved in 2007, an anticonvulsant that reduces nerve excitability
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Duloxetine (Cymbalta), approved in 2008, a serotonin-norepinephrine reuptake inhibitor
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Milnacipran (Savella), approved in 2009, also an SNRI
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Cyclobenzaprine HCl sublingual tablets (Tonmya), approved in August 2025, the first new fibromyalgia medication in over 15 years
Other medications, including low-dose amitriptyline and gabapentin, are commonly prescribed off-label. Clinical guidelines generally advise against opioids for fibromyalgia, as they have not been shown to be effective for this type of pain and carry meaningful risk.
Cognitive Behavioral Therapy (CBT)
CBT has strong research support for fibromyalgia. It helps patients manage pain-related fear and anxiety, and studies show its benefits tend to last longer after treatment ends compared to medication alone.
Exercise and Physical Therapy
Regular, gradually progressing exercise is one of the most consistently supported treatments for fibromyalgia. Aerobic exercise and strength training show the strongest evidence, though yoga, tai chi, swimming, and Pilates have also been shown to help. The key is starting at a low intensity and building up slowly, since overdoing it early can trigger a flare.
Chiropractic Care for Fibromyalgia
This is where a chiropractor for fibromyalgia fits into the bigger picture. Chiropractic care will not cure fibromyalgia, and no responsible provider will claim it does. What it can offer is targeted support for some of the physical contributors that make fibromyalgia symptoms worse:
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Addressing joint restriction and muscle tension that add to overall pain load
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Improving mobility and posture, which can reduce compensatory pain patterns
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Gentle, low-impact adjustments and soft tissue work suited to a sensitized nervous system
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Targeted muscle work such as active release technique or dry needling for specific areas of tension, when appropriate for the individual
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Coordinating care with a patient’s physician, physical therapist, or mental health provider rather than working in isolation
Because physical trauma is one of the documented triggers for fibromyalgia, and because musculoskeletal pain compounds the central sensitization already driving the condition, addressing the physical side of the equation through chiropractic care can be a meaningful piece of a broader fibromyalgia treatment plan. Some patients also find relief through SoftWave therapy, a non-invasive option offered at our clinic for chronic pain and inflammation. At Colorado Injury & Wellness, Dr. Austin Clarke builds care plans around each patient’s specific pain pattern and history rather than applying a one-size-fits-all protocol.
Lifestyle and Self-Management
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Prioritizing sleep hygiene and consistent sleep and wake times
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Pacing activity throughout the day instead of pushing through and crashing
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Stress management techniques such as deep breathing or mindfulness
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Staying active in daily routines and relationships rather than withdrawing, since research shows people who remain engaged tend to do better than those who stop activity altogether
Living With Fibromyalgia
Fibromyalgia is a long-term condition, but it is manageable. Most people find that a combination of medical treatment, physical care, and lifestyle adjustment brings real improvement in both pain levels and daily function. Keeping a simple symptom log can help identify personal triggers, whether that is poor sleep, a stressful week, or overexertion, so you and your care team can adjust the plan accordingly.
When to See a Doctor or Chiropractor
If you have experienced widespread pain for three months or longer, alongside fatigue, sleep problems, or cognitive symptoms like fibro fog, it is worth getting evaluated rather than assuming it will pass on its own. Early diagnosis tends to lead to better long-term outcomes and can reduce the number of unnecessary tests you go through trying to find an explanation.
Frequently Asked Questions
Is fibromyalgia an autoimmune disease?
It’s not officially classified as one, and this remains an actively debated question among researchers. A 2021 study found that antibodies from fibromyalgia patients could produce fibromyalgia-like symptoms in mice, which points to possible immune involvement in at least some cases. Other researchers remain unconvinced that this fully explains the condition. Most experts currently describe fibromyalgia primarily as a central nervous system pain-processing disorder with some inflammatory and immune features still being studied.
Can fibromyalgia be cured?
There is currently no cure for fibromyalgia. However, it can be effectively managed with the right combination of medical treatment, physical therapy or chiropractic care, and lifestyle changes, and many people see significant improvement in their symptoms and quality of life.
What triggers a fibromyalgia flare-up?
Common flare triggers include poor or disrupted sleep, physical overexertion, emotional stress, weather changes, and infections. Keeping track of your personal patterns over time is one of the most useful tools for managing flares.
Is fibromyalgia hereditary?
There is a meaningful genetic component. A 2026 study of over 2.5 million people identified 26 genetic risk regions associated with fibromyalgia, and having a close family member with the condition does raise your own risk. That said, genetics alone do not appear to cause fibromyalgia. Most researchers believe it takes a combination of genetic vulnerability and an environmental trigger, such as an injury, infection, or major stressor, for the condition to develop.
Related Reading
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Osteoarthritis vs Rheumatoid Arthritis: What’s the Difference?
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How Long After a Car Accident Should You See a Chiropractor?
Get Support at Colorado Injury & Wellness
If you are dealing with the widespread pain, fatigue, and stiffness of fibromyalgia and want a care plan that addresses the physical side of your symptoms, Dr. Austin Clarke and the team at Colorado Injury & Wellness are here to help. We work alongside your existing medical care to build a plan focused on your specific pain patterns and daily function. New to our office? Visit our new patient page to see what your first visit looks like and current special offers.
Colorado Injury & Wellness 1819 W Colorado Ave, Colorado Springs, CO 80904, United States Phone: +1 719-471-4174
