Lady Gaga is Vogue’s October cover model, and in the accompanying interview, the pop singer and actress dives into many aspects of her career—like her upcoming role in the movie Joker: Folie à Deux—and her personal life—including some updates on her fibromyalgia diagnosis.

Gaga has dealt with fibromyalgia (a condition that causes widespread pain) for more than a decade, after fracturing her hip on The Born This Way Ball tour in 2012. She first spoke about her diagnosis in her 2017 Netflix film Gaga: Five Foot Two. In the more recent interview with Vogue, she says her 2022 Chromatica Tour “was the first time I’ve performed not in pain in…I don’t even remember.” She also mentions she hasn’t smoked pot in years, saying, “I’ve like, changed. A lot.”

There’s no cure for fibromyalgia, leading people to turn to alternative treatments like marijuana (which could have been the case for Gaga) to relieve pain. Here’s a closer look at fibromyalgia, including what causes it and how it’s managed.

Fibromyalgia isn’t well understood

Fibromyalgia is a chronic condition that causes widespread pain, fatigue, sleep, memory, and mood issues. Researchers think the disorder increases pain by affecting the way the brain and spinal cord process pain signals. Other symptoms can include sleep disturbances and trouble focusing, also known as “fibro fog,” per the Mayo Clinic.

Symptoms can often start up after physical trauma, as was the case for Gaga with her hip fracture. But other things like surgery, infections, or significant psychological stress can trigger it, too. Sometimes it’s a combination of factors over time that set off the condition.

About 2 to 4 percent of people live with fibromyalgia, according to the American College of Rheumatology, and it affects women more than men. People with fibromyalgia are also prone to other conditions like tension headaches, TMJ disorders, irritable bowel syndrome (IBS), and depression and anxiety, per the Mayo Clinic.

A fibromyalgia diagnosis can take time

It can be hard to diagnose fibromyalgia because doctors don’t typically think about it right away. They might have to rule out a bunch of other conditions through blood work and tests first. Most often, people are diagnosed by describing their symptoms in detail to their doctor.

One test that’s been used is called the tender point exam, where doctors press firmly on 18 specific points on the body to see how many were painful. But new guidelines from the American College of Rheumatology say it’s no longer needed to make a diagnosis, per the Mayo Clinic.

You may be diagnosed if you’ve had a widespread dull, constant ache for at least three months in most of these areas: left and right upper region (including shoulders, arms, or jaw); left and right lower region (including hips, buttocks, or legs); and axial region (including neck, back, chest, or abs).

Treatment focuses on managing symptoms

As mentioned, there’s no cure for fibromyalgia, but there are ways to reduce pain. In her Netflix film, Gaga is seen getting deep tissue massages on her neck and shoulders and doing gentle stretches to deal with flares.

Other strategies include getting plenty of movement, especially low-impact exercise like swimming, yoga, tai chi, or walking; getting acupuncture; or going to talk therapy. Your doctor may also prescribe an antidepressant or nerve pain medication. (The three FDA-approved drugs for fibromyalgia are Cymbalta, Savella, and Lyrica.) Stress relief through meditation, deep breathing, and proper rest can also go a long way.

And while cannabis can be a low-risk, short-term pain management method, there’s not enough evidence to support its effectiveness for treating fibromyalgia pain, according to a June 2023 review in Biomedicines¹.

Usually people turn to a combination of these methods to manage their symptoms, and it seems Gaga has found what works for her body.