Fibromyalgia — NZ Condition Guide | KiwiMeds

What is Fibromyalgia?

Fibromyalgia is a chronic condition characterised by widespread musculoskeletal pain, fatigue, sleep problems, and often cognitive difficulties (“fibro fog”). It is classified as a nociplastic pain condition — meaning the pain is real and debilitating, but results from altered pain processing in the nervous system rather than tissue damage.

Overview

Fibromyalgia symptoms include widespread pain (above and below the waist, on both sides of the body, often described as a constant dull ache), fatigue, non-restorative sleep (waking unrefreshed), cognitive problems (difficulty concentrating, memory issues), headaches, irritable bowel symptoms, sensitivity to temperature, light, and sound, and mood problems including anxiety and depression. Fibromyalgia often coexists with other conditions including IBS, tension headaches, and mood disorders.

Treatment in New Zealand

Fibromyalgia management is multidisciplinary. Exercise — particularly aerobic exercise and hydrotherapy — has the strongest evidence and is recommended as a first-line treatment. CBT for pain and sleep hygiene improve outcomes. Medications with evidence include duloxetine (an SNRI), amitriptyline (for sleep and pain), and gabapentin/pregabalin — all funded by Pharmac. Standard pain medicines (NSAIDs, opioids) have limited benefit for fibromyalgia and opioids should generally be avoided.

NZ-Specific Information

Pain New Zealand and the Fibromyalgia Network NZ provide support. Multidisciplinary pain clinics are available but have long wait times. ACC funding may be available if fibromyalgia is related to a work injury or accident.

Frequently Asked Questions

Is fibromyalgia a “real” condition? Absolutely. Fibromyalgia is recognised by the WHO as a real, debilitating condition. Brain imaging studies show altered pain processing. Can fibromyalgia be cured? There is no cure, but symptoms can be significantly reduced with the right combination of physical, psychological, and medical treatment. Is fibromyalgia progressive? Generally not — it does not cause damage to muscles or joints. Symptoms may fluctuate over time.

Supplements That May Support Management

⚠️ Important: The supplements listed below have varying levels of clinical evidence. They are not a substitute for prescribed medications and should only be considered as adjunctive support under the guidance of a qualified healthcare professional. Always inform your GP or pharmacist before commencing any supplement, as interactions with prescribed medicines are possible.

• Vitamin D — Vitamin D deficiency is highly prevalent in fibromyalgia and is associated with increased pain sensitivity and fatigue. Supplementation in confirmed deficiency has demonstrated improvements in pain scores and functional capacity in several trials.
• Magnesium (Malate or Glycinate) — Magnesium malate specifically has evidence for fibromyalgia symptom reduction, addressing hypothesised mitochondrial energy dysfunction in fibromyalgia muscle cells. Doses of 300–450 mg/day of elemental magnesium have demonstrated reductions in tender point count and pain intensity.
• Coenzyme Q10 — Mitochondrial dysfunction is a proposed mechanism in fibromyalgia. CoQ10 at 200–300 mg/day has demonstrated improvements in pain, fatigue, and sleep quality in fibromyalgia patients in clinical studies.
• 5-HTP (5-Hydroxytryptophan) — 5-HTP is a serotonin precursor. Serotonin deficiency is associated with fibromyalgia. Supplementation at 100 mg three times daily has demonstrated improvements in pain, stiffness, anxiety, fatigue, and sleep in randomised trials. Caution: do not combine with serotonergic medications (SSRIs, SNRIs) without medical advice due to serotonin syndrome risk.
• Omega-3 Fatty Acids — Anti-inflammatory omega-3 supplementation reduces central sensitisation-related pain mechanisms. Meta-analyses support modest improvements in fibromyalgia pain outcomes.

Relevant Vaccinations

Individuals living with fibromyalgia may benefit from the following vaccinations. Please discuss your vaccination status with your GP or practice nurse, as eligibility and funding through the New Zealand National Immunisation Schedule may apply.

• Influenza (annual) — Viral illness significantly worsens fibromyalgia flares. Annual vaccination reduces acute illness burden.
• Shingles (Shingrix) — Post-herpetic neuralgia superimposed on fibromyalgia creates extremely difficult-to-treat pain. Shingrix vaccination from age 50 is strongly recommended.
• COVID-19 — COVID-19 and post-COVID syndrome can trigger or worsen fibromyalgia. Maintaining vaccination reduces this risk.

Dietary Guidance

Evidence-based dietary modifications play a meaningful role in the management of fibromyalgia. The following foods are generally recommended as part of a balanced, condition-appropriate diet. A referral to a registered dietitian may be beneficial for personalised nutritional planning.

• Anti-inflammatory dietary pattern (Mediterranean) — Anti-inflammatory dietary patterns are associated with reduced pain sensitivity and better fibromyalgia symptom management. The Mediterranean diet also improves sleep quality and reduces depression, both highly relevant comorbidities.
• Tryptophan-rich foods (turkey, eggs, cheese, seeds) — Tryptophan is the dietary precursor to serotonin, which is implicated in fibromyalgia pain modulation and sleep regulation. Adequate dietary tryptophan is important.
• Adequate protein intake — Supporting muscle function and energy metabolism, particularly important given muscle pain and fatigue in fibromyalgia.
• Limit: caffeine (after midday), alcohol, aspartame — Caffeine disrupts sleep architecture critical for fibromyalgia recovery. Alcohol worsens sleep quality and fatigue. Aspartame may sensitise pain perception pathways in susceptible individuals.
• Vitamin D-rich foods (oily fish, fortified milk) — Given the frequency of deficiency in fibromyalgia, ensuring adequate dietary and supplemental vitamin D is particularly important.

Related Conditions & Medications

Related conditions: Chronic Pain, IBS, Depression.