does stress make fibromyalgia worse
According to research, people with fibromyalgia have said that their symptoms get worse when they are stressed.

Does Stress Make Fibromyalgia Worse?

Fibromyalgia is a common medical condition that causes widespread pain among other debilitating symptoms. It has a serious impact on many areas of a person’s life, causing emotional as well as physical stress. But does stress make fibromyalgia worse? Here’s all you need to know.

What Is Fibromyalgia?

Fibromyalgia is a chronic condition that causes its sufferers to experience pain throughout their bodies. To receive a diagnosis of fibromyalgia, a person must have severe pain in three to six different areas of the body (or mild pain in seven areas or more), symptoms that have been consistent for three months or more and the person must have no other underlying reason for these symptoms

Fibromyalgia can be difficult to diagnose, especially since it shares symptoms with several other conditions. It is a frustrating situation, and to make matters worse, nobody is sure what causes the disease. It has no effective treatment beyond the management of symptoms and trying to prevent fibromyalgia flare-ups.

What Are the Symptoms?

Alongside widespread pain, fibromyalgia causes a variety of other symptoms:

  • Muscle tenderness, stiffness, or spasms.
  • Sleep problems.
  • Fatigue.
  • Difficulty thinking clearly, also known as “fibro fog.”
  • Headaches.
  • Irritable bowel syndrome (IBS).

These symptoms can vary significantly from patient to patient and not everyone with fibromyalgia will have the same experience. However, many people find that their symptoms become worse when they are stressed.

How Stress Affects Fibromyalgia

Although the exact cause of fibromyalgia is a mystery, it appears to be associated with imbalances in several different neurotransmitters. These chemical messengers play a crucial role in the central nervous system and influence both mood and sensations, like pain.

People with fibromyalgia tend to have lower-than-average levels of serotonin, dopamine and norepinephrine. They also have raised levels of substance P, a chemical involved in the pain response. Finally, fibromyalgia can alter levels of cortisol, a hormone that the adrenal glands release during stressful situations.

People with fibromyalgia often report that their symptoms become worse when they are under stress. Therefore, you might expect people with fibromyalgia to have higher-than-average levels of cortisol. However, the opposite seems to be true.

The exact link between cortisol, stress and fibromyalgia is unclear. However, scientists believe that an underlying dysfunction in the way the brain communicates with the adrenal glands is to blame.

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Does Stress Make Fibromyalgia Symptoms Worse?

Fibromyalgia can often flare-up during stressful periods. Furthermore, it often appears for the first time after a physically or emotionally stressful event, including:

  • An infection, illness, or operation.
  • Childbirth.
  • A relationship breakdown.
  • Bereavement.

It is thought that extreme stress could trigger a disturbance in the hypothalamic-pituitary-adrenal (HPA) axis. This is the system that controls the release of cortisol by the adrenal glands.

As we have already mentioned, people with fibromyalgia tend to have lower cortisol levels than usual. Research suggests that this feature could cause symptoms such as pain and fatigue.

Furthermore, disruptions in the release of cortisol throughout the day could contribute to sleep problems. Cortisol levels are meant to peak early in the morning and reduce gradually as the day goes on. However, fibromyalgia can cause it to remain at a steadier level, interfering with the body’s natural sleep-wake cycle.

How Fibromyalgia Patients Can Manage Stress

Since stress can make fibromyalgia symptoms worse, it is essential that patients learn to manage it effectively.

Relaxation Techniques

It may be helpful to learn some relaxation techniques, such as breathing exercises, mindfulness, mediation, or hypnotherapy. It is possible to use these to stay calm when faced with a distressing situation. However, it is also beneficial to practice them regularly to stay on top of things.


Talking therapies, such as cognitive behavioral therapy (CBT), can be useful for people with fibromyalgia. They help to identify and change negative thinking patterns, while teaching new ways to cope with stress.


Exercise is a great way to relieve stress and is important for managing other fibromyalgia symptoms too. However, it is best to avoid high-impact sports and focus on gentle activities instead. Swimming, walking, cycling and yoga are all good options for fibromyalgia.

Support Groups

Joining a support group, either locally or online, is a great way to connect with other people with fibromyalgia. You can share tips about what works and what does not, but most of all, you will find comfort in knowing you are not alone.

Financial Management

Fibromyalgia can affect your ability to work and that can lead to financial stress. The good news is that people with fibromyalgia may be eligible for certain benefits. There is plenty of information available online to help you find out whether you qualify.

Communicate and Educate

Sometimes, it can be difficult for friends and family to comprehend the impact that fibromyalgia has on a person. This can lead to conflicts, relationship problems and additional stress. Explain what you are going through to your loved ones and point them to appropriate resources so they can better understand your needs.

Learn to Say No

Frustrating as it is, fibromyalgia might mean you cannot do as much as you did previously. However, it is essential to avoid overdoing things and making your symptoms worse. Delegate tasks to others whenever possible and do not be afraid to say no to things you cannot handle.

Recognize the Early Signs of Stress

Often, people do not realize how stressed they are until it becomes extreme. Learn to spot the early signs of stress and take action when they occur. Things to look out for include:

  • Tension headaches.
  • Increased frustration or irritability.
  • Worse sleep than usual.
  • Low libido.

If you notice any of these signs, look at what is going on in your life and see what positive changes you can make. Step up your self-care routine and ask for extra support if necessary. By catching your stress early, you stand more chance of getting on top of things before it makes your fibromyalgia worse.