If you’re living with both fibromyalgia and breast cancer, you may wonder whether chemo can cause fibromyalgia or make your symptoms worse. Chemotherapy can cause many side effects, and some of them overlap with fibromyalgia symptoms. That overlap can make chemotherapy side effects feel like a fibromyalgia flare, even when the change is related to treatment rather than fibromyalgia.

If you’re getting chemo and your symptoms change, tell your cancer care team. They can help you sort out whether the symptoms may be related to fibromyalgia, chemotherapy side effects, breast cancer, another condition, or a mix of causes.

Overlapping Fibromyalgia Symptoms and Chemotherapy Side Effects

Fibromyalgia symptoms and chemotherapy side effects can both affect your energy, sleep, thinking, and physical comfort. That overlap can make it hard to tell what’s causing a new or worsening symptom.

Fibromyalgia Symptoms

People with fibromyalgia often have widespread pain, tenderness to touch, muscle and joint stiffness, and numbness or tingling in the arms and legs. They may also have fatigue, trouble sleeping, digestive issues (such as abdominal pain, diarrhea, constipation, and bloating), and “fibro fog,” which can affect focus and memory.

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Chemotherapy Side Effects

Chemotherapy can also cause fatigue, nausea, diarrhea, appetite changes, “chemo brain,” and other side effects. Some chemo medicines used for breast cancer can also cause peripheral neuropathy, which is nerve damage in the hands, arms, feet, or legs.

Peripheral neuropathy can lead to pain, weakness, tingling, numbness, or sensitivity. Numbness or tingling can also happen with fibromyalgia, but it doesn’t always mean you have nerve damage.

A MyBCTeam member explained how chemotherapy left them feeling tired: “I started chemo, and I can’t remember the last time I didn’t feel tired. I feel tired every day even though I sleep well at night.”

Chemo can affect memory and concentration, which may feel similar to fibro fog. Chemo can also affect fast-growing healthy cells in the digestive tract, so digestive side effects may overlap with digestive symptoms from fibromyalgia.

Supporting Your Health While Undergoing Chemo With Fibromyalgia

Just as chemotherapy side effects and fibromyalgia symptoms can overlap, some ways to manage symptoms may overlap, too. Ask your healthcare team which steps are safe for you during breast cancer treatment.

Say Yes to Rest

Conserving your energy and making time to rest can help when fatigue is a problem. Regular exercise can help some people with fibromyalgia, but your activity plan during chemotherapy should match your energy level and your care team’s advice. Start with short, low-intensity exercise sessions and slowly increase the duration, intensity, and frequency as tolerated.

One MyBCTeam member suggested, “Start saving energy by taking shortcuts on some things or getting help from other people with shopping and housework. Put chairs around the house so that you can easily stop and rest if you need to. Plan ahead where possible, and allow plenty of time for travel to appointments so you are not rushing.”

If you have trouble sleeping at night, talk to your doctor. Fibromyalgia care may include sleep and fatigue strategies, such as keeping a sleep routine, winding down before bed, and pacing yourself during the day.

“I worked out of my home during chemo,” shared a MyBCTeam member. “I recall needing to crash every afternoon during chemo sometime between 3 and 4 p.m. Just a half hour helped.”

Get Ahead of Pain

Managing pain is important for people with fibromyalgia, especially while undergoing chemotherapy.

One MyBCTeam member explained, “The thing that bothers me most is pain that comes in different places when there’s no reason for pain to be there. But that’s the way fibro is.”

“It seems to bother me most on cold, damp days. I call them ‘fibro days,’” they said.

Talk with your healthcare team about pain management before taking over-the-counter pain relievers. Your care team needs to consider possible drug interactions between chemotherapy drugs and over-the-counter products, supplements, and other medicines.

Fibromyalgia treatment usually involves more than pain relievers. A treatment plan may include self-management approaches, psychological or behavioral therapy, medications, and movement therapies such as yoga or tai chi.

Certain antidepressants and anti-seizure medicines can help with fibromyalgia pain. Anti-inflammatory pain medicines often aren’t very helpful for fibromyalgia pain itself because fibromyalgia doesn’t cause tissue inflammation, but they may help if you have another painful condition.

Nourish Your Body

Eating can be harder during chemo if you’re dealing with nausea, appetite changes, mouth sores, diarrhea, constipation, or fatigue. If you’re struggling to eat enough, ask your healthcare team whether a registered dietitian can help you get the calories and nutrients you need.

Some research suggests a Mediterranean diet may help with fibromyalgia symptoms, but the evidence is still limited. The Mediterranean diet should not be treated as a proven fibromyalgia treatment during chemotherapy.

Your healthcare team can help you choose an eating pattern that supports your strength and comfort during treatment. Maintaining a healthy weight may improve your symptoms.

Get the Support You Need

Living with fibromyalgia, breast cancer treatment, sleep problems, or fatigue can affect your mood and stress level. You don’t have to manage those feelings alone.

Although family and friends can be helpful, mental health professionals can sometimes support you in ways your loved ones can’t. “I have a therapist, and I love it!” said a MyBCTeam member.

“My husband of 28 years is amazing, but there are things I don’t tell him. I tell my therapist, though, and it lets me get it out. She helps me process my feelings.”

MyBCTeam Members With Fibromyalgia

Some members of MyBCTeam report having fibromyalgia. One member shared, “My fibro is acting up. Sometimes I can’t tell the side effects from chemo and the filgrastim (Neupogen) shots versus my fibro.”

Fibromyalgia symptoms may start after a triggering event, such as injury, surgery, infection, or emotional stress. This doesn’t prove that breast cancer treatment increases fibromyalgia risk, but major physical or emotional stressors may affect fibromyalgia symptoms.

“I feel like I have to be strong when I don’t feel like it because everyone keeps telling me I am so strong,” said another member. “They don’t know how hard it is for me to get out of bed, get dressed, keep a decent house, cook for my kids, and just be a mom when I don’t feel like it.”

Pacing yourself can be helpful with fibromyalgia fatigue, especially if you’re getting chemotherapy at the same time. Try not to use up all your energy at once, because doing too much may worsen fibromyalgia symptoms.

Ask for help when you need it, and try to accept that help without guilt. You may also find it useful to talk with others who understand fatigue and breast cancer, treatment side effects, and chronic pain.