Fibromyalgia and Postural Orthostatic Syndrome (PoTS) often occur together. Both conditions affect women predominantly and the exact causes can be hard to detect.

Symptoms of PoTS and Fibromyalgia

Symptoms of PoTS and fibromyalgia may crossover with other chronic conditions too, like Irritable Bowel Syndrome (IBS), joint hypermobility, and Chronic Fatigue Syndrome (CFS), making a clear diagnosis difficult.

Many people are unable to work, participate in family life, or enjoy any kind of regular exercise due to the pain and distress of their symptoms. Standard treatments for fibromyalgia and PoTS include painkillers, anti-depressants, and beta-blockers, depending on the combination of symptoms.

Unfortunately, long-term use of painkillers can affect stomach and bowel health, causing irritation and constipation.

What alternative treatments are available for PoTS?

Acupuncture has a long history of providing safe, effective relief to painful muscle and joint problems like fibromyalgia.
Acupuncture works by improving the flow of ‘Qi’ (pronounced ‘chee’) or life energy around the body. This doesn’t sound very scientific, and you may wonder how this works!

Researchers have measured the effects of acupuncture, and we know it can;

– Stimulate nerves in muscles and tissues to release endorphins, the body’s own ‘feel good’ chemicals
– Alter the balance of brain chemicals to promote pain relief and lift mood
– Improve blood flow through the tiny blood vessels in muscles and connective tissues
– Reduce muscular inflammation

These powerful effects were demonstrated very well in a Spanish study that looked at the effects of acupuncture versus a placebo over a ten-week period.

Participants receiving acupuncture reported significant improvements in fatigue, pain, anxiety and depression, compared to the placebo group.

In my work as a clinical Acupuncturist, I see many clients with fibromyalgia and associated conditions. Each one is unique, with their own pattern of symptoms and symptom triggers. The beauty of acupuncture is the way it sees each person as an individual – no two fibromyalgia patients receive the same treatment!

As well as working with acupuncture needles, I also discuss food and lifestyle changes with clients. These are simple measure they can take at home, at their own pace, to help ease symptoms. They include dietary changes, sleep support, supplements, movement and exercise, and techniques to deal with stress.


Dietary support for fibromyalgia and PoTS

One of the most important dietary steps to take when managing fibromyalgia or any associated condition like PoTS or IBS, is to eat regularly.

Don’t have long gaps between meals and aim to eat every 4 hours on average. This may mean you need to plan for snacks; that’s fine, make sure to choose something healthy and unprocessed like fruit and nuts, or houmous and oatcakes, and avoid sugary biscuits and chocolate bars.

You may have heard about the benefits of the Mediterranean Diet for managing inflammation. There isn’t one typical Mediterranean Diet as diets vary widely across the countries in this part of the world, but there are some significant similarities;

– Fresh oily fish: wild salmon, mackerel, sardines, pilchards, and herring are rich in omega-3 oils. These healthy oils convert to anti-inflammatory compounds in the body and can support healthy circulation too.

– Using cold-pressed oils; olive oil is a good choice for drizzling over salads and cooked vegetables. It is rich in antioxidants and healthy fats.

– Eating a rainbow; enjoying lots of brightly coloured vegetables every day is a key part of the traditional Mediterranean way of eating. Aim to include at least 5 servings of different coloured vegetables each day. The different colours represent the various anti-inflammatory and protective nutrients found in the vegetables. For example, orange peppers and sweet potatoes are high in beta-carotene, whilst dark green kale and broccoli contain magnesium, sulphur and folates. You may find it easier to eat lightly cooked vegetables rather than raw salads, especially if you are dealing with digestive problems too.

– Enjoy 2-3 brightly coloured fruits too! Blueberries, strawberries, kiwi fruits, satsumas, apples, pears, plums – these are all good choices.

– Drink plenty of water. I see many clients who are simply dehydrated, as this is a major trigger for muscle pains, cramps, headaches, and fatigue. Aim to reduce regular and decaffeinated tea and coffee as much as possible and replace it with 1 – 1.5l of plain warm or room temperature water every day. Add sliced lemon or orange to liven it up – this is a great natural, sugar-free alternative to squash!

Sleep Support

Sleep is vital for helping you manage the symptoms of fibromyalgia, yet the pain and discomfort commonly disrupts sleep.

To help your body establish a sleep/wake rhythm, turn the lights out and settle down to sleep at the same time every night, and set an alarm to wake up at the same time each morning.

Have at least 1 hour of freedom from TV, tablets, mobile phones, and any other blue-light devices before bed. This allows levels of melatonin (the sleep hormone) to start to rise, which in turn helps you drop off to sleep.

Keep your bedroom dark and cool. Being too warm can keep you awake: your core body temperature needs to drop slightly before you can fall asleep. Having said that, if you have cold feet, do use a wheat bag warmer or hot water bottle, as cold feet can keep you awake too!

Movement & Exercise

Joint pains and fatigue can keep you trapped in a vicious cycle. Lack of movement worsens joint problems but being fatigued means you have no energy or motivation to exercise.

Rather than thinking about exercise, consider how you can move each day. If you struggle to move comfortably, start with a simple 10-minute stretching routine whilst lying in bed every morning and evening, or some seated yoga. The important thing is to move each day, to support healthy circulation and detoxification.

Stress Management

Stress is a major trigger for fibromyalgia symptoms, and associated conditions like PoTS and IBS. Our stress response affects digestion, muscular tone, blood pressure, circulation, concentration, and memory. Every system in the body is affected by stress.

You may not be able to remove the sources of stress from your life, but you can control how you respond to them. Simple deep breathing exercises are the quickest and easiest way to relax your mind and body. Practising deep breathing whenever you feel tense and stressed can help you remain calm and reduce the effects of the situation.

Yoga, mindful meditation, and being outdoors amongst nature are other ways to incorporate stress management into your life. Aim to include a pleasurable, relaxing activity each day even if its just a short gentle walk or laughing at a comedy film.


There are a huge number of natural remedies available online or in stores – some proven, many unproven.
For specific supplement advice, ask a trained member of staff in an independent health store, or see a Registered Nutritional Therapist.

One supplement I frequently discuss with clients is magnesium.

Magnesium supports muscle function and energy production in the body and is known to play a role in heart health, blood pressure regulation, fatigue, and migraine. Many people are low in this essential mineral and supplementation may be helpful.

There are many magnesium supplements available; the best absorbed forms include citrate, glycinate and malate. You can also use magnesium externally as a skin spray – this is helpful if you don’t like swallowing tablets!

Remember to check with your GP or specialist before taking any supplements alongside medications, and only take the suggested dosage.

Years of experience in clinical acupuncture have taught me that a multi-pronged approach is the most effective way to manage fibromyalgia. Acupuncture brings fantastic results, and these are strengthened by diet and lifestyle changes that provide a truly transformative experience.


Post by Tiziana Bertinotti who is a York-based acupuncturist and traditional Chinese medicine practitioner and can be contacted via her website: