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Fibromyalgia flare-ups: Causes, symptoms, and management

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What is a flare?SymptomsVs. rheumatoid arthritisTriggersDurationManagementSummary
Fibromyalgia flare-ups involve sudden surges of intensified symptoms, including severe pain and fatigue. A nutrient-dense diet, more physical activity, supportive therapies, and medications may help you manage these flare-ups.
Medically reviewed by Angelica Balingit, MD
Written by Rashida Ruwa, RN
Updated on

Fibromyalgia is a lifelong condition that causes widespread pain in your muscles and bones (musculoskeletal pain). It may also involve fatigue and increased tenderness in specific areas of your body. 

While the exact cause of fibromyalgia remains unknown, researchers believe it may involve a combination of various factors. These factors include genetics, chemical imbalances in the brain, and triggering events. 

Treatment is available and often effective.

What is a fibromyalgia flare-up?

Woman massaging her hand to relief pain caused by fibromyalgia flare-ups.
Photography by AsiaVision/Getty Images

A fibromyalgia flare-up is a sudden and temporary worsening of your condition. During a flare-up, symptoms become more severe and significantly affect your daily life.

Flare-ups may vary in duration and intensity from person to person. Your experience may also differ from one flare to the next.

Flare-ups may last for days, weeks, or even months.

During a flare-up, you may:

  • experience increased pain and tenderness in various parts of your body, such as the muscles and joints
  • notice your skin becoming more sensitive to touch
  • have increased mental and physical fatigue, often leading to difficulty concentrating, recalling information, and sleeping

You may also experience one or more flare-ups during a year. Periods between flare-ups are known as remission and involve less severe or no symptoms.

Symptoms of fibromyalgia flare-ups 

Symptoms of a fibromyalgia flare-up may include:

  • increased overall pain or a specific pain in a particular part of the body (localized)
  • fatigue and exhaustion
  • low mood, including sadness and hopelessness
  • increased sensitivity to things like light and noise
  • difficulties with concentration
  • sleep disturbances like difficulty sleeping (insomnia) and nightmares
  • increased anxiety
  • changes in mood
  • gastrointestinal symptoms like constipation or diarrhea

How different is fibromyalgia from rheumatoid arthritis?

Fibromyalgia and rheumatoid arthritis (RA) are chronic conditions that may cause pain and affect daily life. However, they are different. 

RA is an autoimmune disease that involves your immune system mistaking your joint tissue for foreign invaders. This means immune cells fight your joint tissues to protect you from them, causing inflammation and tissue degeneration.

Fibromyalgia, on the other hand, is not an autoimmune or degenerative condition. But it does affect your daily life and activities.

Other differences in symptoms between fibromyalgia and RA may include:

  • Pain: In fibromyalgia, people experience widespread pain that they often describe as aching or burning. In RA, the pain is usually localized in the joints and is often accompanied by swelling, stiffness, and warmth to the touch.
  • Tender points: Fibromyalgia is characterized by specific tender points on the body that are pressure-sensitive. These tender points are not present in RA.
  • Fatigue: Chronic fatigue is a common symptom in both conditions.
  • Cognitive difficulties: “Fibro fog,” which refers to difficulties with concentration and memory, is a common fibromyalgia symptom. People with RA may also experience cognitive difficulties, but these symptoms may be less severe or frequent.
  • Sleep disturbances: Both conditions may lead to sleep problems, but fibromyalgia is more linked with sleep disturbances such as insomnia.

Both fibromyalgia and RA involve flare-ups:

  • Fibromyalgia flare-ups: These involve increased overall pain, sensitivity to light and noise, and fatigue. Various factors, such as stress and physical exertion, can trigger flares.
  • RA flares: These may involve increased joint pain and stiffness. Various factors, such as infections and emotional stress, can trigger flares. 

Triggers of fibromyalgia flare-ups

Fibromyalgia flare-ups can be activated by a range of factors, including:

  • experiencing emotional or psychological stress
  • pushing yourself too hard physically (overexertion) or engaging in intense physical activities
  • having an illness or infection, like Lyme disease
  • experiencing physical trauma like an injury or surgery 

How long does a fibromyalgia flare-up last?

Flare-ups may last from a few days to weeks, months, or even years. 

The specific duration of a flare-up depends on several factors, including your overall health and well-being:

  • Triggers: If a flare-up is triggered by a specific event or circumstance, such as a stressful event, it may last until the triggering factor is managed.
  • Management and treatment: How well you manage your symptoms and follow your treatment plan may affect the duration of a fibromyalgia flare-up. 
  • Lifestyle factors: Managing stress, being physically active, and following a nutrient-dense diet may help shorten the duration of flare-ups.

How to manage fibromyalgia flare-ups 

While there’s currently no cure for fibromyalgia, it’s a manageable condition. Treatments for this condition aim to lower pain, increase energy levels, and improve mood.

Healthcare professionals may recommend some medications to manage the condition. These may include:

  • serotonin norepinephrine reuptake inhibitors (SNRIs) like duloxetine (Cymbalta) and the only medication approved by the FDA exclusively for fibromyalgia, milnacipran (Savella)
  • selective serotonin reuptake inhibitors (SSRIs) like citalopram (Celexa) and fluoxetine (Prozac)
  • tricyclic antidepressants like amitriptyline (Elavil)
  • antiseizure drugs like pregabalin (Lyrica) and gabapentin (Neurontin)
  • over-the-counter pain relievers like acetaminophen and naproxen 
  • prescription pain relievers like tramadol (Ultram)
  • muscle relaxants like cyclobenzaprine (Amrix)

Other strategies may include:

  • Lifestyle changes: Engaging in regular physical activity, improving sleep hygiene, and practicing stress management techniques.
  • Trigger management: Identifying and avoiding known triggers to lower the chances of flare-ups.
  • Supportive therapies: Trying options like physical therapy, massage, or acupuncture to help reduce pain, improve movement, and promote relaxation.
  • Cognitive behavioral therapy (CBT): Participating in psychotherapy to help you identify negative thoughts and behaviors, as well as develop coping strategies to manage pain, stress, and emotional challenges.

Managing fibromyalgia is a personalized process. What works for one person may not work for another. To develop a treatment plan that addresses your needs and goals, it’s important to work closely with a healthcare professional.

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Fibromyalgia flare-ups are periods of increased symptoms like pain and fatigue. They may last from a few days to several weeks or even months. The duration of a flare-up varies among people and can be influenced by triggers, management strategies, and overall health.

While fibromyalgia is a chronic condition without a known cure, management strategies such as lifestyle changes and medications can help lower the frequency and intensity of flare-ups.

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.

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