Jaw & Head

What It Is

Fibromyalgia is a long-term condition that causes pain all over the body (NHS, 2022a). As well as widespread pain, people with fibromyalgia may have increased sensitivity to pain, muscle stiffness, difficulty sleeping, extreme tiredness (fatigue), problems with memory and concentration (sometimes called "fibro-fog"), headaches, irritable bowel syndrome (IBS), and feelings of frustration, worry or low mood. The symptoms can change, and sometimes suddenly improve or get worse (NHS, 2022a).

The exact cause is unknown, but it is thought to be related to changes in the way the central nervous system (the brain, spinal cord and nerves) processes pain messages (NHS, 2022a).

Symptoms often begin after an event that causes physical or emotional stress, such as a serious injury, an infection, a major operation or significant emotional trauma. In other cases, fibromyalgia develops without any obvious trigger (NHS, 2022b).

Anyone can develop fibromyalgia, but it is more common in women than men, and it typically develops between the ages of 25 and 55 (NHS, 2022a). It is often associated with other conditions, such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and temporomandibular disorder (a jaw condition) (NHS, 2022b).

There is no specific test for fibromyalgia (NHS, 2022a). Doctors used to check for a set of 18 tender points that were painful when pressed, but newer diagnostic criteria no longer use the tender point examination and instead look at the person's range of symptoms (Jurado-Priego et al., 2024).

Fibromyalgia is a recognised long-term condition. NICE guidance classes it as a type of chronic primary pain: long-term pain that is not fully explained by another condition (National Institute for Health and Care Excellence, 2021).

What Is Happening in the Body?

One of the main theories is that, in people with fibromyalgia, the central nervous system has changed the way it handles pain messages, possibly because of changes in chemicals in the nervous system. This may explain the constant pain and the extreme sensitivity to pain that people experience (NHS, 2022b). Researchers call this process central sensitisation (Jurado-Priego et al., 2024).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Fibromyalgia

There is currently no cure for fibromyalgia, but treatment can ease some of the symptoms and improve quality of life. No single treatment works for everyone, and you may need to try a combination to find what suits you (NHS, 2022c). The three main treatments recommended are exercise, talking therapies and medicines (NHS, 2022c).

I can help you start and build up exercise gently, pace your activity and learn relaxation and breathing techniques, alongside gentle hands-on treatment. See the My Approach tab for how I work.

1. Exercise and Physical Therapy

Although physical therapy may not cure the problem, regular exercise has been shown to help reduce pain and improve overall quality of life, and it is one of the main recommended treatments (NHS, 2022c; National Institute for Health and Care Excellence, 2021). Choose a type of exercise you enjoy and can keep doing in the long term (NHS, 2022c).

2. Talking Therapies

Two talking therapies may help reduce pain: cognitive behavioural therapy (CBT), which helps you manage problems by changing the way you think and behave, and acceptance and commitment therapy (ACT), which can improve sleep and reduce pain (NHS, 2022c).

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Antidepressants: some antidepressants (amitriptyline, citalopram, duloxetine, fluoxetine, paroxetine or sertraline) may be prescribed for adults to help with pain, sleep and quality of life, even if you are not depressed. Your doctor should discuss the benefits and downsides with you first (NHS, 2022c; National Institute for Health and Care Excellence, 2021).
Acupuncture: a course of acupuncture can reduce pain in some people with long-term pain, although its effects have only been shown to last up to 3 months (NHS, 2022c).

How I can help (see the My Approach tab)

Gentle, soothing hands-on treatment, adjusted to how you feel that day
A gentle, supervised exercise programme you build up slowly
Pacing, relaxation and breathing techniques

Tips

Genes may play a small part, so some people may be more likely than others to develop fibromyalgia (NHS, 2022b).
If you have a rheumatic condition such as osteoarthritis, rheumatoid arthritis or ankylosing spondylitis, fibromyalgia is more often seen alongside it (NHS, 2022b).
Women are more likely to develop the condition than men (NHS, 2022a).
Physical or emotional events, such as an injury, an infection, an operation or significant emotional trauma, can trigger fibromyalgia or make symptoms appear (NHS, 2022b).
There is little or no evidence that medicines other than the antidepressants listed above help reduce long-term pain (NHS, 2022c). If you already take painkillers or nerve-pain medicines for fibromyalgia, talk to your family doctor or nurse practitioner before making any changes (National Institute for Health and Care Excellence, 2021).
See your family doctor or nurse practitioner if you think you have fibromyalgia. Treatment can ease some of the symptoms, although they are unlikely to disappear completely (NHS, 2022a).

Treatment

My Approach

With fibromyalgia, gentle and regular works better than deep and occasional. Deep or intense work often leaves people sorer afterwards, so I keep sessions soothing and tailored to how you're feeling that day. My aim is to help bring your pain down and help you do more, not to promise it disappears.

I start by asking about your pain, sleep, energy and what good and bad days look like, then assess how you move and where you're most tender. Please tell me about any medicines you take so I can adjust treatment. Your family doctor or nurse practitioner remains the person to confirm the diagnosis and manage your overall care.

Hands-On Treatment

A shorter first session, around half an hour, so we can see how your body responds
Light to moderate pressure, adjusted area by area and week by week
Warmth first, then a slow, soothing full-body relaxation massage, with extra time for the head, neck, shoulders, hands and feet
Gentle trigger point work where it helps, for example in the neck, jaw and temples if they feed headaches
If an area is too tender to touch, I work somewhere else, and on a bad day we go gentler and shorter

Exercise and Pacing

Starting small: gentle walking or swimming at the time of day you have the most energy, building up slowly
Gentle stretching and strengthening, with a home programme between visits
Some soreness for a day or two is common at first; if pain is severe or lasts more than two days, we scale back
Pacing: spreading activity out so a good day doesn't lead to several bad ones

Relaxation and Self-Care

Breathing and relaxation practice
Warm baths or a heating pad at home
Gentle movement such as tai chi or yoga, if you enjoy it
Learning how a sensitised nervous system amplifies pain, which can make flare-ups less worrying

What to Expect

Typical Course

Typical course: Early on, shorter visits about once a week, sometimes twice, then spacing out as you manage more on your own, with a reassessment at about 4 to 6 weeks. Many people notice some easing after four to six sessions, and exercise usually takes six to eight weeks to make a difference. As fibromyalgia is long-term, most people then carry on with a home routine and occasional visits.

What I Focus On

Gentle Relaxation Massage

Pressure Tolerance

Graded Exercise

Pacing

Relaxation Skills

Sources

References

NHS (2022a) Fibromyalgia. Available at: https://www.nhs.uk/conditions/fibromyalgia/ (Accessed: 7 October 2026).
NHS (2022b) Fibromyalgia – causes. Available at: https://www.nhs.uk/conditions/fibromyalgia/causes/ (Accessed: 7 October 2026).
NHS (2022c) Fibromyalgia – treatment. Available at: https://www.nhs.uk/conditions/fibromyalgia/treatment/ (Accessed: 7 October 2026).
National Institute for Health and Care Excellence (2021) Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain (NICE guideline NG193). Available at: https://www.nice.org.uk/guidance/ng193/chapter/Recommendations (Accessed: 7 October 2026).
Jurado-Priego, L.N., Cueto-Ureña, C., Ramírez-Expósito, M.J. and Martínez-Martos, J.M. (2024) 'Fibromyalgia: a review of the pathophysiological mechanisms and multidisciplinary treatment strategies', Biomedicines, 12(7), 1543. doi: 10.3390/biomedicines12071543

Massage therapy · Kitchener–WaterlooFibromyalgia

What It Is

What Is Happening in the Body?

Self-Care & Treatment

How to Treat Fibromyalgia

1. Exercise and Physical Therapy

2. Talking Therapies

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Hands-On Treatment

Exercise and Pacing

Relaxation and Self-Care

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooFibromyalgia

What It Is

What Is Happening in the Body?

Self-Care & Treatment

How to Treat Fibromyalgia

1. Exercise and Physical Therapy

2. Talking Therapies

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Hands-On Treatment

Exercise and Pacing

Relaxation and Self-Care

Typical Course

References

Related Conditions

Headaches

Temporomandibular Joint Dysfunction (TMJ)

Sinusitis

Book a session