Fibromyalgia: When fatigue becomes as disabling as pain

What is fibromyalgia?

Fibromyalgia is a chronic condition characterised by widespread pain throughout the body, heightened sensitivity to pain, and significant variability in symptoms from one person to another. It is frequently accompanied by sleep disturbances, concentration difficulties, mood changes, and persistent fatigue.

Long debated and misunderstood, fibromyalgia is now recognised by the World Health Organization (WHO). It mainly affects women and is often described as an “invisible” illness, as its symptoms are not always detectable through standard medical tests. Despite this, its impact on daily life can be profound.

Chronic fatigue: a key symptom of fibromyalgia

For people living with fibromyalgia, fatigue is not simply a lack of energy. It is a deep, chronic exhaustion that affects the body, mind, and emotions.

This fatigue may be present upon waking, even after a full night’s sleep, and can worsen as the day goes on. It is often unpredictable, fluctuating from day to day depending on activity levels, stress, or other factors. For many patients, fatigue is just as disabling, if not more so, than pain itself.

Why does fibromyalgia cause such intense fatigue?

Sleep disturbances

Sleep problems are extremely common in fibromyalgia. Sleep is often unrefreshing, marked by frequent awakenings, difficulty falling asleep, or the feeling of never truly resting. Poor sleep quality plays a major role in the development and persistence of chronic fatigue.

Dysregulation of the nervous system

Fibromyalgia is associated with dysfunction of the central nervous system, leading not only to increased sensitivity to pain but also to constant strain on the body. This ongoing “alert mode” can drain physical and mental resources, even without significant physical effort.

The burden of chronic pain

Living with constant pain requires continuous attention and energy. This ongoing struggle can lead to profound exhaustion, similar to long-term burnout, which gradually settles in over time.

Chronic fatigue in fibromyalgia vs chronic fatigue syndrome: what’s the difference?

Chronic fatigue is a central symptom of fibromyalgia, but it should not be confused with chronic fatigue syndrome, also known as myalgic encephalomyelitis (ME/CFS). These are two distinct conditions, although they share some overlapping symptoms, such as severe exhaustion and cognitive difficulties.

In fibromyalgia, fatigue is part of a broader symptom profile dominated by widespread pain. In chronic fatigue syndrome, overwhelming exhaustion and intolerance to exertion are the primary features. In some cases, both conditions may coexist, making management even more complex.

The impact of fatigue on daily life

Chronic fatigue linked to fibromyalgia can affect many areas of daily living. It may make it difficult to maintain employment, limit social and family activities, and contribute to isolation.

Because this fatigue is often invisible to others, it can be misunderstood by those around the patient. This lack of understanding may intensify feelings of injustice, guilt, or frustration. The inability to “function as before” can also take a toll on self-esteem and emotional well-being.

Living better with fatigue when you have fibromyalgia

There is no single solution to managing fatigue in fibromyalgia. Many patients emphasise the importance of a comprehensive approach that addresses the physical, psychological, and social aspects of the condition.

Adjusting daily routines, learning to recognise personal limits, and accepting symptom fluctuations are often part of the journey. Complementary approaches, practical adjustments, and support from loved ones can also play an important role, alongside appropriate medical care.

A symptom that is still too often minimised

Despite its major impact, chronic fatigue is still frequently underestimated, both in healthcare settings and in society more broadly. Lack of recognition can delay diagnosis, complicate management, and deepen the sense of misunderstanding experienced by patients.

Raising awareness about fibromyalgia and its many manifestations, including chronic fatigue, is essential to improving recognition of the condition and strengthening patient support.

Fibromyalgia and chronic fatigue: Key points to remember

• Fibromyalgia is a recognised chronic condition characterised by widespread pain, heightened pain sensitivity, and often invisible symptoms.
• Chronic fatigue is one of its central symptoms and can be just as disabling as pain.
• This fatigue is deep, persistent, and not relieved by rest, affecting both body and mind.
• Sleep disturbances, nervous system dysregulation, and the constant burden of pain all contribute to long-term exhaustion.
• Fatigue in fibromyalgia is distinct from chronic fatigue syndrome (ME/CFS), even though some symptoms may overlap.
• It has a significant impact on daily life, work, social relationships, and psychological well-being.
• Better recognition of chronic fatigue in fibromyalgia is essential to improving diagnosis, care, and patient support.

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