Key takeaways

• Fibromyalgia is a long-term pain condition that can cause widespread pain, fatigue, sleep problems, stiffness, and “fibro fog.”
• Researchers have not found one single cause. The leading explanation is altered pain processing in the brain, spinal cord, and nerves, often called central sensitization.
• Common triggers may include physical injury, surgery, infection, emotional stress or trauma, poor sleep, and family/genetic risk.
• Fibromyalgia is diagnosed clinically. A medical provider considers symptom history, pain distribution, severity, duration, and whether another condition better explains the symptoms.
• There is no known cure, but symptoms can often be managed with movement, education, sleep support, stress management, medications when appropriate, and gentle hands-on care such as manual therapy or myofascial release.

What is fibromyalgia?

Fibromyalgia is a chronic condition that affects how the nervous system processes pain. The main symptom is widespread body pain, but fibromyalgia can also affect energy, sleep, memory, mood, digestion, and daily function.

This is one reason fibromyalgia can feel confusing. The pain may move, flare, or feel intense even when X-rays, MRI results, or routine blood tests do not show tissue damage. That does not mean the pain is imagined. It means the pain system itself may be on high alert.

At Manual Therapy Associates in Arvada, our goal is to help people understand their pain, move more comfortably, and build a plan that supports function without pushing the body into repeated flare-ups.

What causes fibromyalgia?

What causes fibromyalgia? The honest answer is that there is rarely one single cause. For many people, fibromyalgia develops when several factors combine and the nervous system becomes more sensitive to pain signals.

A helpful way to think about it is a volume knob. In a healthy pain system, the brain filters signals and turns the volume up or down based on threat, injury, and context. In fibromyalgia, the volume can stay turned up. Normal pressure, movement, stress, or poor sleep may feel painful or exhausting because the nervous system is processing signals differently.

This process is often described as central sensitization. It involves the brain, spinal cord, and nerves becoming more reactive. That can lead to hyperalgesia, where pain feels stronger than expected, and allodynia, where normally non-painful sensations feel painful.

7 factors that may trigger or contribute to fibromyalgia

1. Central sensitization: amplified pain signals

Central sensitization is one of the most important concepts in fibromyalgia. The problem is not simply in the muscles or joints. The nervous system may become more sensitive, so pain signals are amplified and harder to quiet.

This helps explain why fibromyalgia pain can be widespread rather than limited to one injured body part. It also helps explain why symptoms may flare after poor sleep, stress, weather changes, overexertion, or illness.

2. Genetics and family history

Fibromyalgia often runs in families, which suggests that genetics may play a role. Having a family tendency does not guarantee that someone will develop fibromyalgia, but it may make the nervous system more vulnerable when other triggers are present.

3. Physical trauma, surgery, or injury

Some people notice fibromyalgia symptoms after a car accident, fall, surgery, repetitive strain, or another physical stressor. The original tissue injury may heal, but the nervous system can remain protective and reactive.

This is especially important after motor vehicle accidents or persistent musculoskeletal pain, because early education, gentle movement, and appropriate treatment may help reduce fear, guarding, and long-term sensitivity.

4. Infection or illness

Fibromyalgia can begin or worsen after certain infections or illnesses. Researchers are still studying why this happens, but immune activation, inflammation, sleep disruption, and stress on the body may all play a role in sensitizing the pain system.

5. Chronic stress or emotional trauma

Stress does not mean fibromyalgia is “all in your head.” It means the body and brain are connected. Long-term stress and trauma can affect the autonomic nervous system, sleep, muscle tension, breathing patterns, and pain sensitivity.

For some people, stress management, counseling, cognitive behavioral therapy, acceptance and commitment therapy, mindfulness, breathing work, or relaxation training can become valuable parts of a broader fibromyalgia treatment plan.

6. Poor sleep and fatigue cycles

Fibromyalgia and sleep often feed each other. Pain makes it harder to sleep, and poor sleep lowers the body’s pain threshold. Over time, this can create a cycle of pain, fatigue, brain fog, reduced activity, and more pain.

A plan that supports consistent sleep habits, gentle movement, pacing, and nervous-system calming can help many people reduce the intensity of flare-ups.

7. Overlapping health conditions

Fibromyalgia often overlaps with other conditions, including headaches or migraine, TMJ-related jaw pain, irritable bowel syndrome, anxiety, depression, autoimmune or rheumatic conditions, and chronic fatigue symptoms.

Because symptoms overlap, it is important to work with a qualified medical provider. The goal is not only to name fibromyalgia, but also to identify treatable contributors that may be making symptoms worse.

Fibromyalgia symptoms: what it can feel like

Fibromyalgia symptoms vary from person to person and can change from day to day. Common symptoms include:

• Widespread muscle, joint, or soft-tissue pain
• Tenderness or increased sensitivity to pressure
• Fatigue that does not improve fully with rest
• Trouble falling asleep, staying asleep, or waking unrefreshed
• Morning stiffness or stiffness after sitting
• Brain fog, trouble concentrating, or memory difficulty
• Headaches, migraine, or jaw/TMJ pain
• Numbness, tingling, burning sensations, or heaviness in the limbs
• Irritable bowel symptoms such as bloating, constipation, or diarrhea
• Dizziness, lightheadedness, anxiety, low mood, or feeling overwhelmed

Because fibromyalgia symptoms can resemble other conditions, new, severe, or changing symptoms should be evaluated by a healthcare professional.

How fibromyalgia is diagnosed

Fibromyalgia is diagnosed through a clinical evaluation, not a single blood test or scan. A provider will usually review your symptom history, pain locations, sleep, fatigue, cognitive symptoms, medical history, medications, and physical exam findings.

Modern diagnostic criteria focus on widespread pain, symptom severity, and symptoms lasting at least three months. The older tender-point exam may still be discussed, but it is no longer the only way fibromyalgia is identified.

Testing may still be recommended to check for other conditions, such as thyroid disease, inflammatory arthritis, autoimmune disease, anemia, vitamin deficiencies, or neurological problems. This is not because fibromyalgia is not real; it is because the best treatment plan depends on an accurate diagnosis.

Can fibromyalgia be cured?

There is currently no known cure for fibromyalgia. The good news is that many people can reduce symptoms, improve daily function, and regain confidence with the right combination of care.

Fibromyalgia treatment works best when it is personalized. A plan may include medical care, movement, manual therapy, sleep support, stress regulation, pacing strategies, nutrition support, and mental health support when needed.

Fibromyalgia treatment: what helps manage pain?

The most effective plan is usually not one treatment. It is a combination of small, consistent strategies that help calm the nervous system and rebuild tolerance over time.

How manual therapy may help fibromyalgia

Manual therapy is not a cure for fibromyalgia, and it should not be aggressive. For a sensitized nervous system, gentler is often better. The purpose is to help the body feel safer with movement, reduce protective muscle tension, improve soft-tissue mobility, and support a gradual return to activity.

At Manual Therapy Associates, fibromyalgia care may include myofascial release, gentle joint or soft-tissue techniques, stretching, posture and movement education, breathing and relaxation strategies, and a home program matched to your tolerance level.

A good session should leave you feeling supported, not pushed beyond your limits. If a technique causes a prolonged flare, the plan should be adjusted. Progress is built through consistency, trust, and the right dose of movement and hands-on care.

Fibromyalgia treatment in Arvada, CO

If you live near Arvada, Wheat Ridge, Westminster, Golden, Lakewood, or the northwest Denver area, Manual Therapy Associates can help you explore whether a gentle, hands-on physical therapy approach is appropriate for your symptoms.

We start by listening to your history, identifying what worsens or eases symptoms, assessing movement and soft-tissue sensitivity, and building a plan that fits your life. The goal is not to force your body to “push through.” The goal is to help your nervous system and body relearn safe, comfortable movement.

Manual Therapy Associates is located at 12001 W. 63rd Place, Suite 202, Arvada, CO 80004. Call or text 303-668-2898 to ask whether manual therapy may be a good fit for your fibromyalgia symptoms.

When to seek medical care right away

Fibromyalgia can cause intense symptoms, but some symptoms need prompt medical evaluation. Seek medical care right away if you have:

• Chest pain, trouble breathing, fainting, or sudden weakness
• New loss of bladder or bowel control
• Fever, unexplained weight loss, or night sweats
• New severe headache, vision changes, confusion, or neurological symptoms
• Rapidly worsening pain after injury or trauma
• Severe depression, suicidal thoughts, or feeling unsafe

Frequently asked questions

What causes fibromyalgia?

Fibromyalgia usually does not have one single cause. Research points to changes in how the brain, spinal cord, and nerves process pain. Genetics, physical injury, infection, surgery, chronic stress, trauma, poor sleep, and other health conditions may all contribute.

Is fibromyalgia real if my tests are normal?

Yes. Fibromyalgia pain is real. Routine imaging or blood tests may be normal because fibromyalgia is related to pain processing and nervous-system sensitivity rather than obvious tissue damage on a scan.

What does fibromyalgia pain feel like?

People describe fibromyalgia pain as aching, burning, throbbing, stabbing, heavy, or tender. It may move around the body and often comes with fatigue, poor sleep, stiffness, brain fog, headaches, or digestive symptoms.

How is fibromyalgia diagnosed?

A healthcare provider diagnoses fibromyalgia by reviewing your symptoms, pain distribution, symptom severity, duration, and physical exam findings. Tests may be used to check for other conditions that can mimic or worsen fibromyalgia symptoms.

Can fibromyalgia be cured?

There is no known cure for fibromyalgia, but symptoms can often be managed. Many people improve function and quality of life with a personalized plan that includes movement, sleep support, stress regulation, education, medication when appropriate, and therapy.

Does manual therapy help fibromyalgia?

Manual therapy may help some people with fibromyalgia reduce muscle guarding, improve comfort with movement, and tolerate exercise better. It should be gentle, individualized, and used as part of a broader care plan.

What triggers fibromyalgia flare-ups?

Common flare triggers include poor sleep, physical overexertion, emotional stress, illness, weather changes, prolonged inactivity, and sometimes food or medication changes. Keeping a symptom diary can help identify personal patterns.

Should I exercise if I have fibromyalgia?

Exercise can be helpful, but it should begin gently and progress slowly. Low-impact movement, mobility work, water exercise, and light strengthening are often easier to tolerate than high-intensity exercise at the beginning.

Medical disclaimer

This article is for general education and is not a substitute for medical diagnosis or treatment. Always consult a qualified healthcare provider about new, severe, or changing symptoms and before starting a new treatment or exercise program.

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