Is Fibromyalgia Purely Psychological?

Fibromyalgia is a condition characterized by widespread pain and other somatic or physical symptoms like headaches, tender point pain, irritable bowel syndrome, fatigue etc. There are psychological features like depression, sleep disturbances and mood changes as well that arise with fibromyalgia syndrome.

The main controversy is it that many physicians believe this is a psychological condition and this is sometimes strengthened by the fact that the condition is diagnosed on the basis of history.

Thus as a summary some of the points that raise conviction that fibromyalgia may be a psychological disorder include:-

  • Physical examination and laboratory testing are usually non specific for this condition except for the presence of pain on characteristic soft tissue locations, termed tender points. There is however no pathology of the tissues at these points.
  • Antidepressants and drugs that modify the serotonin and norepinephrine in the brain seem to provide relief in fibromyalgia. In addition, cognitive behavioral therapy also helps patients with this condition. This strengthens the arguments of the camp that does not believe fibromyalgia is a true disease.
  • The camp that does not see fibromyalgia as a true physical disease considers it a 'non-disease'. Many of the patients with fibromyalgia continue to shuttle between numerous physicians and undergo numerous costly and sometimes unnecessary tests and ineffective treatments before the diagnosis. It has been seen that the mean duration of symptoms before the diagnosis of fibromyalgia is five years.
  • Several critics have also pointed out that malingering is a major problem in diagnosis of fibromyalgia. The problem is further aggravated by the potential of availability of compensation for the condition. Due to the lack of specific diagnosis and availability of information on tender points etc. patients may malinger more effectively.

Fibromyalgia - a true physical disease?

The points in favour of fibromyalgia being a true physical disease include the fact that there are several physical symptoms associated with the condition. These include migraine, irritable bowel syndrome etc.

Another point in favour of fibromyalgia being a truly recognizable condition includes the fact that in 1990 American College of Rheumatology devised classification criteria for fibromyalgia and several studies showed that based on these fibromyalgia can be differentiated from other rheumatic diseases, with an accuracy of 85%.

Furthermore fibromyalgia may present independently of any other medical disorder but may also be associated with other chronic rheumatic diseases, including rheumatoid arthritis, systemic lupus erythematosus, and osteoarthritis etc.

Fibromyalgia is also associated with some poorly understood syndromes like depression, irritable bowel syndrome, and chronic fatigue syndrome.

The basis of the widespread pain has been found in the interactions of abnormal peripheral and central pain mechanisms. There are changes in sleep patterns, mood disturbances and these are closely associated with the pain symptoms.

New research has found associations between fibromyalgia symptoms and growth hormone, the hypothalamic-pituitary-adrenal axis, serotonin and noradrenaline in the brain. This suggests altered stress regulation as well as neurohormonal changes resulting in fibromyalgia.

Further Reading

Last Updated: Feb 26, 2019

Dr. Ananya Mandal

Written by

Dr. Ananya Mandal

Dr. Ananya Mandal is a doctor by profession, lecturer by vocation and a medical writer by passion. She specialized in Clinical Pharmacology after her bachelor's (MBBS). For her, health communication is not just writing complicated reviews for professionals but making medical knowledge understandable and available to the general public as well.


Please use one of the following formats to cite this article in your essay, paper or report:

  • APA

    Mandal, Ananya. (2019, February 26). Is Fibromyalgia Purely Psychological?. News-Medical. Retrieved on June 24, 2024 from

  • MLA

    Mandal, Ananya. "Is Fibromyalgia Purely Psychological?". News-Medical. 24 June 2024. <>.

  • Chicago

    Mandal, Ananya. "Is Fibromyalgia Purely Psychological?". News-Medical. (accessed June 24, 2024).

  • Harvard

    Mandal, Ananya. 2019. Is Fibromyalgia Purely Psychological?. News-Medical, viewed 24 June 2024,


  1. John Gearheart John Gearheart United States says:

    Of the five points favoring fibromyalgia as being a real disease, the only point I found to support this theory in any way was the last, "New research has found associations between fibromyalgia symptoms and growth hormone, the hypothalamic-pituitary-adrenal axis, serotonin and noradrenaline in the brain. This suggests altered stress regulation as well as neurohormonal changes resulting in fibromyalgia." But, even this shows only a correlation and not causation.

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
Post a new comment

While we only use edited and approved content for Azthena answers, it may on occasions provide incorrect responses. Please confirm any data provided with the related suppliers or authors. We do not provide medical advice, if you search for medical information you must always consult a medical professional before acting on any information provided.

Your questions, but not your email details will be shared with OpenAI and retained for 30 days in accordance with their privacy principles.

Please do not ask questions that use sensitive or confidential information.

Read the full Terms & Conditions.

You might also like...
Case study: Cannabis might dampen the pain, but amplify the psychosis!