Natural Remedies for Fibromyalgia: What the Evidence Supports

01What

What is fibromyalgia?

• Widespread pain lasting more than three months.
• Fatigue and poor-quality, unrefreshing sleep.
• Difficulties with memory and concentration (“fibro fog”).
• Increased sensitivity to pain, touch, noise, light or temperature.
• Headaches, irritable bowel symptoms and low mood are common.
• The NHS notes that symptoms often fluctuate, with flare-ups triggered by stress, poor sleep or overexertion.

02Exercise

Exercise: the best-supported remedy

The EULAR recommendations gave exercise the only “strong for” recommendation in fibromyalgia management. A Cochrane review of aerobic exercise found that it may improve health-related quality of life, pain, stiffness and physical function. Strength training and aquatic exercise also show benefits. The key is to start gently and build up slowly, as doing too much too soon can trigger flares. Walking, cycling, swimming or exercising in a warm pool are good options.

03Plan

How to start exercising with fibromyalgia

• Start with 5–10 minutes of gentle activity on most days.
• Increase by a few minutes every week or two.
• Aim eventually for 20–30 minutes of moderate activity, several times a week.
• Add light strength exercises two or three times a week.
• Choose low-impact activities such as walking, swimming or cycling.
• Expect some temporary soreness; reduce intensity rather than stopping completely during a flare.

04Mind

Mind–body therapies

• Tai chi and qigong: gentle movement and breathing; supported by the EULAR recommendations.
• Yoga: may improve pain, sleep and mood.
• Mindfulness: can reduce stress and pain-related distress.
• Relaxation techniques: slow breathing and progressive muscle relaxation.
• These approaches combine physical activity with stress reduction.

05Psych

Psychological approaches

Cognitive behavioural therapy helps people manage pain, cope with flares, improve sleep and address worry and low mood. It does not mean pain is “in your head”; it targets the way stress, sleep and thoughts interact with pain. EULAR recommends CBT particularly for people with mood problems or unhelpful coping strategies. Multicomponent programmes combining education, exercise and psychological strategies are also recommended.

06Sleep

Improving sleep

• Keep regular bedtimes and wake times.
• Limit caffeine after midday and avoid alcohol close to bedtime.
• Create a cool, dark, quiet bedroom.
• Wind down with a warm bath or relaxation.
• Avoid long daytime naps.
• For more strategies, see insomnia.

07Pacing

Pacing and energy management

• Break tasks into smaller chunks with rests in between.
• Avoid “boom and bust” cycles of overdoing it on good days.
• Plan the week to balance demanding and restful activities.
• Prioritise what matters most.
• Use a diary to identify triggers for flares.

08Other

Other self-care options

• Heat: warm baths, showers or heat packs can ease pain and stiffness.
• Hydrotherapy: exercise in warm water; recommended by EULAR.
• Massage: may help some people temporarily; evidence is limited.
• Acupuncture: received a weak recommendation from EULAR.
• Gentle stretching for stiffness.
• Tender muscle spots are discussed in trigger point therapy.

09Diet

Diet and supplements

There is no specific fibromyalgia diet with strong evidence. A balanced diet, healthy weight and limiting alcohol support overall health. Some people find that certain foods worsen gut symptoms, which may overlap with irritable bowel syndrome. Supplements such as magnesium, vitamin D, turmeric, CoQ10 and others are widely promoted, but evidence is limited or inconsistent. Vitamin D supplements are worthwhile if you are deficient. Discuss supplements with a doctor or pharmacist, as some interact with medicines.

10Medicines

Where medicines fit in

Natural approaches work best as the foundation of treatment. EULAR suggests medicines such as low-dose amitriptyline, duloxetine or pregabalin for some people with severe pain or sleep problems, while advising against strong opioids. Standard anti-inflammatory painkillers are often not very effective in fibromyalgia. A doctor can help weigh the benefits and side effects.

11Flares

Managing flare-ups

• Reduce activity rather than stopping completely, and return gradually.
• Use heat, gentle stretching and relaxation.
• Prioritise sleep and rest breaks.
• Keep a diary to spot triggers such as stress, overexertion, poor sleep or weather changes.
• Have a flare plan agreed with your doctor or physiotherapist.
• Remind yourself that flares usually settle.

12Work

Living and working with fibromyalgia

• Ask about workplace adjustments, such as flexible hours, breaks or an ergonomic workstation.
• Plan demanding tasks for times of day when you feel best.
• Explain the condition to family and friends so they can support you.
• Join a support group or self-management programme.
• Look after your mood; chronic pain and low mood often interact.
• Our guide to burnout may help if you feel exhausted.

13Myths

Common myths

• Myth: fibromyalgia is imaginary. Fact: it is a recognised condition involving changes in pain processing.
• Myth: rest is best. Fact: gradual exercise is the most effective treatment.
• Myth: a special diet cures it. Fact: no diet has been shown to cure fibromyalgia.

14Summary

Key points to remember

• Exercise is the best-supported treatment for fibromyalgia.
• Tai chi, yoga, CBT and hydrotherapy also help.
• Pacing and good sleep reduce flares.
• Evidence for most supplements is limited.