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Fibromyalgia

Widespread muscle pain and heightened sensitivity occur when the nervous system overreacts to normal sensations.

Fibromyalgia is a chronic condition that causes widespread pain and tenderness in the muscles, ligaments and other soft tissues. Unlike pain from injury or inflammation, fibromyalgia stems from heightened pain sensitivity in the nervous system. This refers to the brain and spinal cord overreacting to pain signals.

The condition can affect people of all ages, though it is most common in adults between 30 and 60 years old. While fibromyalgia is not life-threatening, it can have a major impact on daily activities, energy levels and overall well-being.

What are the stages of Fibromyalgia?

Fibromyalgia can progress in stages. However, the pace and pattern vary between individuals. By recognising these stages, it helps patients understand what to expect and manage their condition more effectively:

Stage 1: Early awareness

 

  • You may notice occasional aches, fatigue or poor sleep that are easy to dismiss as overwork or stress.
  • Pain may affect one or two areas, such as the neck or shoulders and comes and goes.

Stage 2: Widespread discomfort

 

  • Pain becomes more persistent and spreads to multiple areas of the body.
  • Sleep disturbances and tiredness start to interfere with daily functioning.
  • You may begin seeking medical help for unclear or generalised pain.

Stage 3: Chronic fibromyalgia

 

  • Pain is constant and may vary in intensity from day to day.
  • Fatigue, headaches and mental fog (fibro fog) become more pronounced.
  • Emotional effects such as frustration, anxiety or low mood may appear.

Stage 4: Flare and recovery cycles

 

  • Symptoms fluctuate with flare-ups triggered by stress, weather or physical strain.
  • Patients learn to identify triggers and manage symptoms through lifestyle and therapy.

How does Fibromyalgia impact quality of life?

Daily life can feel unpredictable when pain, stiffness and fatigue vary from day to day. Additionally, ordinary tasks, from household chores to professional work, may become challenging to the point that they disrupt sleep. This only adds to the exhaustion.

Over time, the condition can reduce independence and confidence. But with the right management plan, many patients regain energy and control over their daily lives.

What causes Fibromyalgia?

The development of fibromyalgia involves a complex interaction between the brain, nerves and hormones. Rather than stemming from direct injury or inflammation, it arises from abnormal pain processing within the central nervous system. This means that the body becomes overly sensitive to pain signals.

Some of the underlying mechanisms are:

  • Genetic influence – certain genes that affect how the brain handles pain and stress may predispose individuals to developing fibromyalgia, especially when combined with environmental stressors.
  • Central sensitisation – the brain and spinal cord amplify pain messages, causing even mild pressure or movement to feel painful. Over time, this hypersensitivity becomes habitual and the nervous system reacts excessively to normal sensations.
  • Altered neurotransmitter balance – changes in brain chemicals such as serotonin, dopamine and norepinephrine affect how pain signals are transmitted and perceived. Reduced levels of these neurotransmitters lower the body’s ability to regulate pain and stress responses.
  • Disrupted stress response – the body’s natural stress-control system (the hypothalamic–pituitary–adrenal axis) may become imbalanced, leading to constant tension and fatigue. Chronic stress also increases levels of cortisol and adrenaline, further heightening nerve sensitivity.
  • Poor restorative sleep – deep sleep is crucial for muscle recovery and pain regulation. When sleep is disrupted, the body cannot reset its pain thresholds, worsening fatigue and discomfort.
Hormonal changes and stress responses make women more prone to fibromyalgia, often affecting the neck, shoulders, back and hips.

What are the symptoms of Fibromyalgia?

Pain and fatigue are the hallmark symptoms, but the condition affects far more than just the muscles. The common complaints include:

  • Aching, throbbing or burning pain in multiple areas of the body.
  • Difficulty concentrating or remembering details.
  • Frequent headaches or jaw discomfort.
  • Increased sensitivity to touch, sound or temperature.
  • Morning stiffness and muscle tightness.
  • Numbness, tingling or temperature sensitivity in the hands and feet.
  • Persistent tiredness despite adequate sleep.

What triggers a Fibromyalgia flare-up?

Flare-ups can be unpredictable, but they are often brought on by specific triggers. This may include, but is not limited to:

  • Hormonal shifts – menstrual cycles or menopause may influence flare frequency.
  • Illness or infection – even mild infections can temporarily intensify symptoms.
  • Stress or emotional strain – anxiety and tension can heighten nerve activity.
  • Overexertion – intense physical activity or repetitive movement.
  • Lack of sleep – fatigue amplifies pain sensitivity and slows recovery.
  • Diet and dehydration – skipping meals or consuming excess caffeine or alcohol can trigger discomfort.
  • Cold or humid weather – sudden temperature changes can worsen stiffness.

Who is at risk of developing Fibromyalgia?

Anyone can experience chronic muscle pain. However, some people are more likely to develop the condition due to several factors, such as:

  • Age – most cases occur between 30 and 60 years old, when the body’s stress tolerance and hormonal balance naturally shift.
  • Gender – women are significantly more affected than men. Hormonal fluctuations, especially changes in oestrogen, are thought to increase pain sensitivity and affect how the nervous system responds to stress.
  • Family history – having a close relative with fibromyalgia or other pain disorders suggests a genetic link that may make an individual more susceptible.
  • Other chronic pain conditions – people with arthritis, irritable bowel syndrome (IBS) or chronic fatigue syndrome are more likely to develop overlapping symptoms due to shared pathways in the nervous system.
  • Infections or illness – certain viral or bacterial infections may overstimulate the immune and nervous systems, precipitating the condition in predisposed individuals.
  • Chronic stress or trauma – prolonged emotional strain or a history of physical or psychological trauma can heighten nervous system sensitivity, acting as a trigger for symptom onset.
  • Sleep problems – long-term sleep deprivation disrupts the body’s ability to recover and regulate pain perception, increasing vulnerability.
Overactive pain pathways can make even mild pressure around the knees feel painful, despite no visible joint damage.

What are the possible complications if treatment is delayed?

Delaying treatment can allow symptoms to worsen. It also impacts overall health and well-being. Some of the potential complications include:

  • Continuous and widespread pain that becomes harder to manage.
  • Cognitive difficulties affecting work performance.
  • Dependency on pain medication without long-term improvement.
  • Emotional effects such as anxiety or depression.
  • Reduced mobility or avoidance of physical activity.
  • Severe fatigue and poor sleep quality.

How is Fibromyalgia diagnosed in Singapore?

Because the symptoms can overlap with other conditions, the diagnosis is made through careful assessment and exclusion of other causes. It typically involves:

  • Physical examination – gentle pressure is applied to specific tender points across the body to identify pain sensitivity and muscle tightness. 
  • Symptom evaluation – our doctor reviews the history, duration and pattern of pain, as well as fatigue, sleep quality and cognitive symptoms. Widespread pain lasting at least 3 months is a defining feature.
  • Exclusion testing – blood work or imaging may be ordered to rule out thyroid disorders, arthritis or autoimmune conditions.

How is Fibromyalgia treated in Singapore?

Shockwave therapy uses focused acoustic waves to relax tight muscles, stimulate healing and relieve chronic pain without surgery.

The treatment for fibromyalgia focuses on controlling pain, improving sleep and supporting emotional health through a blend of medical, physical and lifestyle therapies.

Medication-based management

  • Antidepressants – certain medications help regulate pain-related brain chemicals and improve sleep.
  • Muscle relaxants – reduce muscle tension and aid relaxation at night.
  • Pain relievers – non-steroidal anti-inflammatory drugs (NSAIDs) and neuropathic pain medications can ease muscle and joint discomfort.

Physical and supportive therapy

  • Physiotherapy – gentle movement exercises, stretching and posture correction help maintain flexibility.
  • Occupational therapy – encourages activity pacing and ergonomic adjustments to reduce fatigue.
  • Massage or hydrotherapy – relieves muscle tightness and promotes relaxation.

Advanced and regenerative treatments

  • Shockwave therapy – uses controlled acoustic waves to stimulate healing in soft tissues, reduce muscle stiffness and enhance long-term pain relief.
  • Ultrasound-guided trigger point injections – deliver precise medication into tight muscle bands or tender areas to relieve tension, improve blood flow and restore movement.

Lifestyle and holistic approaches

  • Balanced nutrition – anti-inflammatory foods and adequate hydration support muscle and nerve health.
  • Better sleep habits – maintaining a consistent sleep routine improves recovery and pain control.
  • Low-impact exercise – regular activities such as yoga, swimming or walking improve stamina and mood.
  • Stress management – mindfulness, counselling or relaxation therapy can help reduce emotional triggers.

Summary

Targeted physiotherapy helps restore flexibility, build strength and improve daily function in those living with fibromyalgia.

Living with fibromyalgia can be challenging, especially when pain, fatigue and poor sleep interfere with daily life. Yet with the right care, recovery and comfort are within reach. It is important to understand that early and consistent management makes a lasting difference. By seeking timely treatment and working closely with our care team, you can regain control, rebuild strength and move towards a more active, balanced life.

If you have been experiencing pain that impacts your day-to-day life, then it is best to have it assessed. Get in touch with us today to schedule an appointment with our doctors.

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