Fibromyalgia Symptoms and Stress

Can Stress Make Fibromyalgia Worse?

If you've ever noticed that your fibromyalgia symptoms become more intense during a stressful week, after a major life event, or when you're feeling emotionally overwhelmed, you're not imagining it. Many people living with fibromyalgia identify stress as one of their most consistent symptom triggers. This does not mean that stress causes fibromyalgia. Instead, research suggests that stress can amplify existing symptoms by increasing the sensitivity of the nervous system.

When the body perceives stress—whether it is physical, emotional, or related to poor sleep—it activates the body's natural stress-response systems. In people with fibromyalgia, these systems appear to function differently than they do in individuals without the condition, contributing to heightened sensitivity to pain and other sensory signals (Clauw, 2014; Häuser et al., 2015).

This increased sensitivity can affect many aspects of daily life. During periods of heightened stress, people with fibromyalgia often experience more widespread pain, greater fatigue, poor sleep, increased brain fog, digestive symptoms, headaches, and greater difficulty regulating their emotions. Research suggests that these changes occur because stress influences how the brain and nervous system process pain, regulate stress hormones, and communicate with other body systems (Galvez-Sánchez & Reyes del Paso, 2020).

A helpful way to think about it is that stress can temporarily "turn up the volume" on an already sensitive nervous system. As a result, symptoms may become more intense even though there has been no new injury or damage to the body. Understanding this connection can help explain why learning effective stress-management strategies is an important part of comprehensive fibromyalgia treatment.

Does Stress Cause Fibromyalgia?

The short answer is no—current research does not support the idea that stress alone causes fibromyalgia. Fibromyalgia is a complex medical condition involving changes in nervous system function, genetics, and a variety of biological and environmental factors. While researchers continue to study exactly why fibromyalgia develops, there is no evidence that stress by itself is responsible for causing the condition (Clauw, 2014; Häuser et al., 2015).

That said, stress can play an important role in how fibromyalgia symptomsare experienced. Physical stressors, such as an illness, surgery, or injury, as well as emotional stressors like work pressures, relationship challenges, or major life changes, may trigger the onset of symptoms in some individuals who are already biologically predisposed to developing fibromyalgia. Once the condition is present, ongoing stress can increase the sensitivity of the nervous system, making symptoms such as pain, fatigue, poor sleep, brain fog, and digestive problems feel more intense (Galvez-Sánchez & Reyes del Paso, 2020).

Understanding this distinction is important. If stress caused fibromyalgia, then simply reducing stress would eliminate the condition—and we know that is not the case. However, learning effective ways to manage stress is one of the most valuable tools for reducing symptom flare-ups and improving quality of life.

Stress Management Strategies for Fibromyalgia

Because stress can increase the sensitivity of the nervous system, learning effective ways to manage stress is an important part of living well with fibromyalgia. The goal is not to eliminate stress—an impossible task for most of us—but to help your body respond to it in a healthier, more balanced way. Research shows that evidence-based approaches such as cognitive behavioral therapy (CBT), mindfulness practices, relaxation training, regular physical activity, good sleep habits, and pacing daily activities can help reduce the impact of stress on fibromyalgia symptoms (Macfarlane et al., 2017; Arnold et al., 2019). Even small, consistent changes—such as taking a short walk, practicing slow breathing for a few minutes, maintaining a regular sleep schedule, or setting realistic limits on your time and energy—can make a meaningful difference over time.

It's also important to recognize that stress management looks different for everyone. What helps one person feel calmer and more resilient may not work as well for someone else. Finding the right combination of strategies often involves some trial and adjustment, guided by your symptoms, lifestyle, and personal goals. Working with a psychologist who specializes in fibromyalgia can help you identify your unique stress triggers, develop practical coping skills, and build long-term resilience. Rather than avoiding life's challenges, the goal is to strengthen your ability to navigate them with greater confidence, helping to reduce fibromyalgia symptom flare-ups and improve your overall quality of life. Recent research continues to support the value of psychological interventions—including CBT and mindfulness-based therapies—not only for reducing emotional distress but also for improving pain, physical functioning, and health-related quality of life in people living with fibromyalgia (Bernardy et al., 2018; Arnold et al., 2019; Macfarlane et al., 2017).

Key Takeaways

  • Stress does not cause fibromyalgia.

  • Stress can make symptoms worse.

  • Stress affects everyone differently.

  • Managing stress is an important part of treatment.

  • You can build resilience.

References

American College of Rheumatology. Fibromyalgia.

Bernardy K, Klose P, Welsch P, Häuser W. Efficacy, acceptability and safety of cognitive behavioural therapies in fibromyalgia syndrome: A systematic review and meta-analysis of randomized controlled trials. European Journal of Pain. 2018.

Clauw DJ. Fibromyalgia: A Clinical Review. JAMA. 2014;311(15):1547–1555.

Häuser W, Ablin J, Fitzcharles MA, et al. Fibromyalgia. Nature Reviews Disease Primers. 2015;1:15022.

Galvez-Sánchez CM, Reyes del Paso GA. Diagnostic Criteria for Fibromyalgia: Critical Review and Future Perspectives. Journal of Clinical Medicine. 2020;9(4):1219.

Arnold LM, Bennett RM, Crofford LJ, et al. AAPT Diagnostic Criteria for Fibromyalgia. The Journal of Pain. 2019;20(6):611–628.

Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Annals of the Rheumatic Diseases. 2017;76(2):318–328.

Considering treatment for fibromyalgia? At McLean Health Psychology Specialists, we provide individual, evidence-based care for adults living with fibromyalgia, chronic pain, and complex medical conditions. If you're ready to work with a clinician who specializes in the unique challenges of fibromyalgia, we invite you to schedule a consultation and learn how health psychology can support your treatment journey.

Learn more about our fibromyalgia treatment program.

About the Author

This article was written by Catherine DeBoer, PsyD, ABPP, a Board-Certified Clinical Health Psychologist and fibromyalgia treatment specialist located in McLean, VA. The information provided is based on current scientific research and clinical expertise and is intended for educational purposes only. It should not be considered a substitute for personalized medical advice, diagnosis, or treatment.

© 2026 Catherine DeBoer, PsyD, ABPP. All rights reserved. No portion of this publication may be reproduced, distributed, or transmitted in any form or by any means without prior written permission, except for brief quotations used for educational or scholarly purposes with appropriate attribution.