Ajax Harwood Clinic
Fibromyalgia
In fibromyalgia the nervous system amplifies pain signals, so pain is felt widely through the body and at a much lower threshold than usual — the pain is entirely real, but it comes from how the signals are processed rather than from damage in the places that hurt.
Contact us promptly if
Not an emergency, but worth being seen sooner rather than waiting it out.
- New weakness, numbness in a clear pattern, or loss of bladder or bowel control
- Joints that are visibly swollen, hot, or stiff for more than an hour every morningSwelling is not a feature of fibromyalgia and points towards an inflammatory arthritis.
- Fever, night sweats, or losing weight without trying
What usually happens
Normal blood tests and scans are what we expect to find, and they are not evidence that nothing is wrong. There is no test that shows fibromyalgia, so the diagnosis is made from the pattern — which is a different thing from a diagnosis of exclusion.
Sleep, mood and pain drive each other in a loop. Poor sleep lowers the pain threshold measurably by the next day, pain wrecks sleep, and low mood does both. Which is why treating sleep often does more for pain than anything aimed at pain directly.
Activity helps, but the way it is introduced decides whether it helps or harms. The common pattern is doing a great deal on a good day and paying for it for a week; starting deliberately below what you can manage and increasing slowly is what actually builds capacity.
Medication has a real but limited role here, and the drugs that work best for ordinary pain tend to work poorly for this kind. That is a statement about the mechanism, not about how bad your pain is.
Fibromyalgia often sits alongside other conditions rather than instead of them. Having it does not protect you from developing something else, so new or different symptoms still deserve looking at.
At your appointment
We will check for the conditions that can look like this — thyroid problems, inflammatory arthritis, anaemia — with a focused set of tests rather than an open-ended search.
We will ask about sleep and mood in some detail, not because we think they are the cause, but because they are the levers that move pain the most.
We will build an activity plan that starts below what you can currently do, which often feels counterintuitive, and increases on a schedule rather than on how you feel that day.
We will review the medications you are on honestly, including stopping the ones that are not earning their place.
"Should I be tested?" for fibromyalgia
Last reviewed 2026-10-07
You may want a blood test to prove your pain is real. That makes sense, especially if past tests came back normal. With fibromyalgia, normal results are what we expect to find. There is no blood test or scan that shows fibromyalgia. The diagnosis comes from your pattern of pain, tiredness, and poor sleep. We still run a small set of tests. These check for other causes that can look similar, like thyroid problems or anemia. Swollen or hot joints are not part of fibromyalgia. If you have those, we look for a different cause instead. Your pain is real, even though the tests look normal.
Does this sound like your pattern?
There is no blood test or scan for fibromyalgia. Doctors recognise it from a pattern of symptoms, and these are the parts of that pattern:
- Pain in many places at once: on both sides of your body, and above and below your waist
- Pain that has been going on for at least 3 months
- Along with the pain, at least one of these: tiredness, waking up unrefreshed, or trouble thinking or remembering
Normal blood tests do not count against it. With fibromyalgia, normal results are what we expect to find.
Swollen or hot joints, fever, or losing weight without trying are not part of fibromyalgia. They point to a different cause, and a doctor should look at them.
A few questions, about 2 minutes. Your answers stay on this device. Nothing is sent or saved.
Worth asking
- Have we ruled out the conditions that can look like this?
- How do I start being more active without setting off a flare?
- What can be done about my sleep?
- Is any medication likely to help me specifically?
Curious what your doctor is weighing up? The clinical tool we use for fibromyalgia is open to anyone — it is detailed and written for clinicians, and you are welcome to read it.
Open the clinician reference →General health information for Ajax Harwood Clinic patients and the public — not medical advice, and not a substitute for seeing your own doctor. In an emergency call 911.