Fibromyalgia: Breaking the Myths and Finding a Way Forward
For too long, people living with fibromyalgia have been told that their pain “isn’t real,” that “it’s just stress,” or that “they need to stay positive.”
These messages are not only dismissive — they are damaging. They reinforce stigma, delay diagnosis, and deepen the isolation that so often accompanies chronic pain.
It’s time to replace myth with understanding and compassion.
Myth 1: “Fibromyalgia isn’t real.”
Fact: Fibromyalgia is a real and recognised pain condition.
The International Association for the Study of Pain (IASP) defines it as a nociplastic pain disorder — a condition where the nervous system becomes hypersensitive and amplifies pain signals even without ongoing tissue injury.
So while scans or blood tests might appear “normal,” the pain is very real. It arises from how the brain and spinal cord process pain messages — the body’s alarm system misfires and keeps ringing, even when there’s no danger.
Myth 2: “You just need to exercise or think positively.”
Fact: While movement, sleep, and mindset are part of recovery, fibromyalgia isn’t cured by willpower.
Effective treatment takes an interdisciplinary approach: medication, psychological therapies, physiotherapy, pacing, nutrition, and pain education all play essential roles.
People living with fibromyalgia are not “weak” or “lazy” — they are managing a condition that requires both medical insight and self-management skills, not blame.
Myth 3: “It’s all in your head.”
Fact: Pain is always processed by the brain — but that doesn’t mean it’s imagined.
Fibromyalgia involves central sensitisation — the brain’s alarm system becomes overactive, sending pain signals even when there’s no ongoing injury. People may also become hypersensitive to light, sound, touch, and even smell.
Fatigue, sleep problems, and “brain fog” often accompany the pain, making daily life exhausting and unpredictable.
So, what is fibromyalgia?
Fibromyalgia is a nociplastic pain condition, which means:
Pain lasts at least three months
It is widespread, not confined to one area
It cannot be explained by injury or nerve damage alone
There is increased sensitivity to pain and sensory input (light, sound, smell)
People often experience:
Severe fatigue and unrefreshing sleep
Cognitive difficulties (“brain fog”)
Depression or anxiety
Headaches, abdominal pain, and stiffness
This is not “psychological weakness” — it’s a nervous system in distress that can be stabilised with the right care.
Why validation matters
When a person with fibromyalgia hears, “Your scans are clear, there’s nothing wrong,” what they actually hear is, “I don’t believe you.”
This invalidation can be devastating.
Validation — listening, believing, and acknowledging — is not optional. It’s the foundation of healing.
Effective Treatment Strategies
There’s no single “cure,” but there are many effective ways to live well. Treatment works best when it’s individualised, multidisciplinary, and compassionate.
Medication
Used for symptom relief, not cure:
SNRIs (e.g. duloxetine, venlafaxine)
Tricyclic antidepressants (e.g. amitriptyline)
Anticonvulsants (e.g. pregabalin, gabapentin)
Sleep aids (e.g. zolpidem) if needed
Opioids and anti-inflammatories have little role and may worsen outcomes.
Movement and Pacing
Gentle movement retrains the nervous system to feel safe again.
Physiotherapists can teach pacing — balancing activity with rest to avoid the “boom-and-bust” cycle common in fibromyalgia.
Sleep, Nutrition, and Gut Health
Sleep restoration is essential.
An anti-inflammatory diet — rich in plants, omega-3 fats, and minimal processed foods — supports both gut and nervous system health.
Emerging research even explores how the microbiome influences pain sensitivity.
Psychological Therapies
Therapies like CBT, ACT, and DBT help people manage distress, accept limitations, and build meaningful lives.
DBT’s emphasis on radical acceptance and emotion regulation can be particularly powerful in helping people reduce suffering and live with greater self-compassion.
Education and Mindset
Understanding how pain works — through Pain Neuroscience Education (PNE) — helps to quiet the fear response.
When people understand why they hurt, they begin to move again, rebuild trust in their bodies, and reclaim their lives.
The Path Forward
Fibromyalgia challenges both patients and clinicians to rethink pain.
It’s not a failure of resilience — it’s a condition of a sensitised nervous system that needs validation, science, and care.
When we listen deeply, collaborate across disciplines, and support the person — not just the diagnosis — we help them find a way back home to themselves.
By Dr Michelle Beukes-King
If you’re living with chronic pain and wanting practical tools to cope, connect, and rebuild your life, my online ACT for Chronic Pain group may be a good fit for you.
You’ll learn evidence-based skills in a supportive community — all from the comfort of home.
