Which nonpharmacologic strategies complement pharmacologic therapy for fibromyalgia?

• A. All of the above
• B. Regular exercise
• C. Sleep hygiene
• D. Cognitive behavioral therapy

Answer: (A)

Managing fibromyalgia effectively involves a multimodal approach where lifestyle and psychological strategies complement medications. Regular exercise, including low‑impact aerobic activity and strength training, improves pain, function, mood, and sleep, and can help reduce central sensitization that contributes to widespread pain. Sleep hygiene is crucial because disrupted sleep amplifies pain and fatigue in fibromyalgia; establishing a consistent schedule, a conducive sleep environment, and routines that promote restorative sleep can lessen overall symptom burden. Cognitive behavioral therapy helps by changing unhelpful pain thoughts, reducing catastrophizing, and improving coping strategies, which in turn can lessen perceived pain and improve sleep and functioning. When these nonpharmacologic strategies are used alongside pharmacologic therapy, they address different aspects of the condition and often lead to better overall outcomes than medication alone. All of these strategies together form a complementary, synergistic approach.