Fibromyalgia (or fibromyalgia syndrome, FMS) is a chronic condition characterised by widespread pain and fatigue, plus a whole load of other debilitating symptoms, with a prevalence of between 1.3-7.3% in the general population (see website UK Fibromyalgia). ‘Causes’ are not clear and varied, including  viruses, bacteria, stress, impaired liver function, low immunity and food allergies.

A natural approach using a wide range of approaches such as relaxation, massage, diet, herbs and exercise can be very beneficial in managing FMS and the condition requires an approach that addresses multiple aspects of functioning.

Stress issues and adrenal function

Stress is probably central to the development of FMS. In acute stress the adrenals produce adrenaline which reduces circulation to the gut, reproductive and urinary tracts and generally reduces secretions such as digestive juices, protective mucous in the gut, respiratory tracts, eyes, mouth and serous fluids in the joints with associated symptoms. In chronic stress, cortisol is secreted by the adrenals which raises blood sugar for energy production but eventually the adrenals may become depleted and unable to produce enough cortisol with widespread impairment of function.

‘Adaptogens’ are a class of herbs that aid the stress response, reducing stress on the adrenals and include herbs such as Ashwaganda, which also has a relaxing and anti-inflammatory effect. Other ‘nervine’ herbs such as St. John’s wort and valerian can support the functioning of the nervous system and reduce symptoms of depression which is common in FMS.

Nutritional imbalances

Poor nutrition may make the body more vulnerable to the negative effects of stress and less able to carry out normal cellular and tissue functions such as muscle energy production, healing/tissue repair, immune function and detoxification of waste products and toxins by the liver. These could all contribute to the systemic imbalances seen in FMS. A healthy diet should be high in fruits, vegetables, essential fatty acids and avoid refined and processed foods such as wheat products, sugar and processed fats. Oxidative stress markers in plasma have been shown to be higher in FMS sufferers (Cordero et al., 2008) and a diet high in antioxidant fruits, veg, nuts and seeds is indicated. Nutritional imbalances may be exaccerbated by poor digestion in FMS leading to compromised absorption of nutrients.

Circulation and muscle tension:

Pain in muscles and ‘tender points’ may be associated with a build-up of lactic and uric acids and other waste products of metabolism due to poor blood circulation which not only provides oxygen for energy production but also aids removal of waste products. Herbs such as chilli, ginger and prickly ash bark are used to support peripheral circulation and of course chilli and
ginger can readily be added to the diet in the form of warming stews and curries. Exercise is also beneficial for circulation and moderate exercise has been shown to be useful in FMS. Elimination of waste products may be encouraged with herbs that increase diuresis and liver function. Poor circulation may be secondary to muscular tension, which inhibits blood flow through capillaries, so relaxation of muscle tissues using massage and herbal therapy may be useful, using herbs such as cramp bark and lobelia both orally and as a muscle rub. Muscle tension itself may be associated with stress, lack of available energy for cell functioning or poor healing due to lack of restorative sleep; herbs that aid healing and healthy connective tissue, such as gotu kola, can be helpful. Muscle tension may also cause nerve pain if it causes impingement of nerves if they pass betweeen contracted muscle/tender points and bone. Nerve disruption associated with the sternocleidomastoid muscle in the neck, may cause disrupted messages to be sent to the brain about spatial positioning and cause dizziness; disrupted circulation to the thalamus, the relay point for all sensory and motor impulses, may also be associated with ‘clumsiness’.

Sleep disturbance

Sleep disturbance is almost universal in people with FMS and tends to be associated with non-restorative sleep and in studies of people with FMS, alpha wave patterns have been shown to interrupt the delta wave (deep) sleep phase. Delta phase sleep is crucial as this is when melatonin is secreted by the pineal gland, which causes secretion of growth hormone and increased levels of active thyroid hormone T3; these are both crucial for healing and energy production. Melatonin is manufactured from serotonin and levels of serotonin have been shown to be low in FMS.

A wide variety of herbs can be used to encourage healthy sleep, including passionflower, wild lettuce and California poppy and there are many herbs used as analgesics to reduce pain.

Neurotransmitter deficiencies

Chronic pain exhausts the body’s production of mood-enhancing endorphins and serotonin deficiency, associated with FMS, may exaccerbate this problem and increase both sensation of pain and depression

Digestive problems

IBS-like symptoms are common in FMS and it is important to deal with them, to restore good digestion. With impaired digstion, absorption of nutrients is reduced, adding the ill health and partially digested food molecules may irritate the gut and encourage the growth of harmful bacteria, leading to compromised integrity of the gut wall and absorption of food molecules into the bloodstream with consequent strain on the immune system. If there are problems with digestion, approaches that may be of benefit are supplementing digestive enzymes (which are under-secreted in stress), pro- and pre-biotics and herbs to soothe any inflammation of the gut such as slippery elm bark, marsmallow, plantain. Small amounts of herbs called ‘bitters’ such as
gentian, artichoke leaf and angelica may also stimulate digestion and supplementing with the amino acid glutamine may be beneficial for healing the gut as it can become depleted in stress.

Urinary tract problems

Genitourinary discomfort is commonly associated with FMS and may be diagnosed as ‘interstitial cystitis’, associated with painful spasms and inflammation. It has been suggested that urinary oxalates may cause irritation and a diet low in oxalates may help to alleviate symptoms.


Headaches may be due to impaired circulation or impinged nerves in the neck due to muscle tension. Muscle tension may also be due to spinal misalignments. Where tension and poor circulation are an issue, herbs such as ginger, cinnamon and cramp bark may be useful



Cordero MD et al, 2008CLIN. BIOCHEM

Caution: If using plants for medicinal purposes, obtain from a reputable source. The information is offered for its educational value only and should not be used to diagnose, treat, or prevent disease; please contact your health care practitioner.