Fibromyalgia (Disability)

Utilize the chronic pain rules listed below to depict the pain & pain management aspects of fibromyalgia.

Each day, roll 1d10 to determine the hero’s pain level for the day, then make a Constitution saving throw. The DC should be determined based on the severity of the pain the hero is trying to manage:

- 1–3: The hero has mild pain, causing stiffness and discomfort. They have disadvantages in dexterity and dexterity-based checks. Heroes also have disadvantages in initiative rolls.

- 4–6: The hero is dealing with moderate pain, making it difficult to perform most physical activities. In addition to the above, they have a disadvantage on all strength and strength-based checks.

- 7–9: The hero is in severe pain and has trouble focusing on anything other than their pain. In addition to the above, heroes are disadvantaged in intelligence, intelligence-based checks, and saving throws.

- 10: The hero is in so much pain that they cannot function. All ability checks and saving throws should be made at a disadvantage, and the hero’s speed should be halved.

(optional: The hero has an advantage on concentration checks because they’re used to managing pain.)

The inhibitions put in place by the hero’s pain level can be mitigated with healing, which will trigger a second constitution saving throw.

Additionally, you can either use the chronic fatigue rule listed below or use this variant fatigue rule listed here: If your pain level increases by more than one category in a single night, you gain a point of exhaustion. The optional rules for chronic fatigue can also be applied.

Roll a d20 at the end of a long rest. On a roll of 2 or lower, take one level of fatigue. This number can be adjusted for the severity of chronic fatigue to increase or decrease the odds of being penalized. (Optional: Critical failure adds two levels of fatigue. Alternative optional rule: you take twice as long to remove fatigue as other players.)

When you take this disability, you may take an additional feat or give a +1 to two ability scores or a +2 to one ability score.