By Dave Williams, PhD

It is tempting to assume that symptom flares of Fibromyalgia (FM) would be associated with the stress of national emergencies. But data suggest otherwise.  For example, during  911, individuals in Washington DC  who had FM, reported no worsening of pain in the days following the disaster compared to the weeks prior. 1 Thus simply having a national crisis does not predict worsening FM.

Flares in FM are more closely tied to an individual’s daily routine than to any given news event. The Coronavirus is a different type of crisis, however.  It does directly impact people’s daily routine.  It contains elements of anxiety over health risks, behavioral and social disruption, and uncertainty. The combination of these elements can make a recipe for worsening FM symptoms because the crisis can affect people at the individual level.

During times of crisis, individuals with FM tend to rise to the occasion in order to protect loved ones from adversity and to do what it takes to promote the welfare of their neighborhoods and communities. While such a community focus is laudable and even expected, it can also mean that routine self-care gets disrupted or abandoned. Disrupted routines result in symptom flares which unfortunately diminishes the capacity of people with FM to be helpful and to deal with the health crisis effectively.

Much of self-care for FM requires maintaining routine bodily rhythms such as having regular sleeping and waking times, pacing one’s self through daily tasks, practicing mindfulness or yoga, and eating a healthy diet.  During times of crisis, these routines can get disrupted resulting in behavioral overdoing, no relaxing balance to the stress of the crisis, and less restorative sleep. It can seem like just when you need to function most, FM makes it impossible.

So that you can be maximally effective in helping yourself and others, maintain as much consistency in your daily routine as possible. For example, if you’ve been exercising at a gym, be sure to continue that routine even if you must be creative and adjust to exercising in your home. Similarly, you may need to practice yoga or meditation at home rather than in a group setting. The key is to maintain your body’s rhythm of health.  When following a routine, your body learns to adjust to the demands you make of it. Suddenly changing that rhythm can cause a flare of symptoms.  FM does not like surprises.

If you’ve fallen off of your routine and need to restart a body rhythm for pacing, sleeping, or meditating, you can usually re-establish a rhythm if you are consistent for about 8 days. For more ideas about how you can take control of some of your FM symptoms see Lynne Matallana’s article, Taking Charge, Despite Coronavirus”.

Finally, we don’t know how long our lives will be disrupted by this virus.  Thus, it is more important than ever to establish healthy routines and rhythms that can be used over the long haul.  Just like when you are on an airplane and get instructed to put the oxygen mask on first before helping others, taking care of yourself with healthy routines first can facilitate your participation in efforts to deal more effectively with the national health crisis.


  1. Williams, DA, Brown, SC, Clauw, DJ, Gendreau, RM (2003). Self-reported symptoms before and after September 11 in patients with Fibromyalgia. JAMA, 289(13), 1637-8.