If you’re one of the millions of adults in the United States living with fibromyalgia, you know that symptoms like pain and fatigue can make it difficult to function. This is especially true during a fibromyalgia flare-up.
Fibromyalgia is defined by lasting pain throughout your body, which is often accompanied by tenderness in your muscles, joints, and other soft tissues. It’s difficult to come up with one-size-fits-all advice for dealing with fibromyalgia symptoms, since the condition affects everyone differently.
“Some people may be working 80 hours a week, while other people can’t function at all. And it’s all under the fibromyalgia title,” says Daniel Arkfeld, MD, a rheumatologist at Keck Medicine of USC at the University of Southern California in Los Angeles.
Still, there is some widely applicable advice for living with fibromyalgia. These self-care tips can help you reduce or distract from pain and fatigue, and make the most of the energy you have.
Do Listen to Your Body
Fibromyalgia fatigue can make it difficult to get through routine daily tasks.
Dr. Arkfeld describes energy as a resource that’s easily exhausted in people with fibromyalgia. “If they have 10 energy boxes a day, and they are being asked to use 20 energy boxes, they’re going to be chronically fatigued,” he says.
This fatigue isn’t just in your head. There’s evidence that it’s a result of brain and hormone changes, including sensory overload and sleep disruption. If your body’s giving you signs that you’re overwhelmed, listen up.
Don’t Try to Muscle Through
No matter what level of fibromyalgia pain you experience, it isn’t necessarily something you have to just live with.
“There are a lot of things that can be done for pain, depending on what’s causing it,” says Arkfeld. He points to medications, high-quality sleep, and correcting hormone or nutrient deficiencies as areas that can be beneficial.
In the meantime, it can backfire if you force yourself to work through the pain and fatigue.
While it’s not always feasible to put life on pause, overdoing it can worsen symptoms. Try to pace yourself as much as possible. This may look like reorganizing your schedule to allow for more breaks, reducing your commitments, or asking for help from friends and family.
Do Use the Energy You Have
Pay attention to when you tend to have the most energy and the least pain. For example, some people feel best earlier in the day. Knowing when your symptoms ebb and flow can help you plan your activities and get things done.
“Fatigue requires not overdoing it but not underdoing it,” says Arkfeld, adding that the more active you are when you have the ability to be, the more energy you’re likely to have in general.
Plus, you’ll feel better about getting things done, which can boost your mental health — something that’s especially important for people with fibromyalgia.
Don’t Ignore Your Mental Health
Addressing mental health challenges like depression and anxiety is considered a key part of fibromyalgia treatment, not separate from it, says Arkfeld.
Seeing a therapist or psychologist can also be highly beneficial for many people with fibromyalgia. The common therapy technique called cognitive behavioral therapy is a mainstay of fibromyalgia treatment. It can help people deal with negative thoughts and identify activities that can make their symptoms worse.
Certain antidepressants are also approved as fibromyalgia treatments, including duloxetine (Cymbalta), milnacipran (Savella), and cyclobenzaprine hydrochloride (Tonmya).
Arkfeld notes that many people with fibromyalgia are especially sensitive to the side effects of antidepressants, even at low doses. Look for a mental health provider who is familiar with fibromyalgia.
Do Get Enough Sleep
Sleep can be an especially difficult area if you have fibromyalgia. Poor sleep can be both a cause and an effect of fibromyalgia pain.
“In deep sleep, you release a lot of neurochemicals,” says Arkfeld, which are highly beneficial in reducing pain and fatigue. And for many people with fibromyalgia, “interrupted sleep seems to aggravate pain quite a bit,” he says.
To increase the odds of getting a good night’s sleep, Arkfeld suggests reducing stimulating activities before your bedtime, and sticking to a regular sleep schedule.
Another option for better sleep may be a treatment called low-dose naltrexone. It’s not approved for fibromyalgia but is sometimes prescribed off-label. “That does make people sleep deeper, which seems to help with the pain of fibromyalgia quite a bit,” says Arkfeld.
Some research suggests that this treatment may be a safe option to reduce fibromyalgia symptoms. However, larger studies are needed to confirm its safety and efficacy.
Do Exercise With Caution
Physical activity is important, but it’s just as important to be measured and realistic about your capabilities, says Arkfeld. “You have to slowly increase your activities, because if you do too much, you’re just going to flare and end up taking steps backward.”
One way to ensure that you make steady progress without pushing yourself too hard is to participate in a graded exercise program. This gradual approach can help you build strength and endurance over time.
It can also be helpful to take frequent breaks throughout your workout to help your muscles recover. Try exercises like stretching, water aerobics, resistance training, and tai chi.
Do Seek Help and Support
When you have fibromyalgia, you should expect a lot out of your relationship with your doctor, says Arkfeld. “Even though you might look really healthy, when you go under the surface, there are a lot of issues” when it comes to levels of various hormones and antibodies (immune system proteins) he says.
For example, Arkfeld says, many of his patients with fibromyalgia also have low thyroid hormone levels — but it’s not always clear early on when such tests are warranted. It’s important that your doctor takes the time to obtain a complete medical history and perform a thorough exam. This can help them arrive at a diagnosis and determine what additional testing might be helpful.
But, according to Arkfeld, physicians “have to really engage the patients, get to know them, build trust. And that can take months.”
It’s also ideal when you can lean on friends or family members for support, and let them know what you’re experiencing with fibromyalgia pain and fatigue. They probably can’t see these symptoms and may not know about it in the moment. “At home, if the spouse or family are supportive, it can be very helpful,” says Arkfeld.
The Takeaway
Managing fibromyalgia involves listening to your body's signals and avoiding overexertion, which can exacerbate fatigue and pain.
Good sleep hygiene may help alleviate symptoms, and exploring therapies such as lower-dose medication might help improve restfulness.
Exercise like water aerobics and tai chi is beneficial but should be approached gradually.
Addressing mental health is also crucial. Ask your doctor about incorporating cognitive behavioral therapy or antidepressants.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Hujjat SF et al. Tonmya (cyclobenzaprine hydrochloride sublingual tablets): first FDA-approved therapy for fibromyalgia in over 15 years. Annals of Medicine and Surgery. October 6, 2025.
Yang J et al. The Safety and Efficacy of Low-Dose Naltrexone in Patients with Fibromyalgia: A Systematic Review. Journal of Pain Research. March 21, 2023.
Christine Alexopoulos is a physician assistant in outpatient rheumatology at the University of Southern California in Los Angeles. She practices at the intersection of rheumatology and primary care, with a clinical focus on patients with complex, multisystem conditions including fibromyalgia and Ehlers-Danlos syndrome. Working closely with her supervising physician, she helps manage a high volume of these patients, emphasizing longitudinal care, symptom integration, and patient education.
Alexopoulos has three years of clinical experience, including two years in primary care and one year in rheumatology. She is the first advanced practice provider in her department, contributing to the development of clinical workflows and expanding access to rheumatologic care within the practice.
She received a bachelor's degree in biology from Chapman University, followed by a master’s degree in kinesiology from California State University in Long Beach. She completed her master of physician assistant practice at the University of Southern California, where she was inducted into Pi Alpha, the national physician assistant honor society. She is a board-certified physician assistant.
In addition to her clinical work, Alexopoulos is beginning to contribute to medical education through delivering continuing medical education lectures at USC. Her scholarly work includes a published case report in Current Rheumatology Reviews, with additional research and publications in development.
Alexopoulos is a professional member of the the Association of Rheumatology Professionals and the American College of Rheumatology. Her professional interests include improving care delivery for patients with chronic pain syndromes, advancing the role of physician assistants in rheumatology, and integrating primary care principles into subspecialty practice.
A freelance health writer and editor based in Wisconsin, Quinn Phillips has a degree in government from Harvard University. He writes on a variety of topics, but is especially interested in the intersection of health and public policy. Phillips has written for various publications and websites, such as Diabetes Self-Management, Practical Diabetology, and Gluten-Free Living, among others.
