Objective To investigate the clinical effect of massage combined with internal heated needle therapy in the treatment of fibromyalgia syndrome. Methods A total of 40 patients with primary fibromyalgia syndrome were randomly divided into treatment group and control group using a random number table, with 20 patients in each group. The patients in the treatment group were given massage combined with internal heated needle therapy, and those in the control group were given oral amitriptyline. The changes in clinical outcome, Visual Analogue Scale (VAS) score, and number of tenderness points were observed after 4 weeks of treatment. Results The treatment group had a better clinical outcome than the control group (P<0.05). Both groups had significant changes in the number of tenderness points after treatment (P<0.05), and there was a significant difference in the degree of change between the two groups (P<0.05). The control group had no significant change in VAS score after treatment (P>0.05), while the treatment group had a significant change in VAS score after treatment (P<0.05); there was a significant difference in the degree of change between the two groups (P<0.05). Conclusion Massage combined with internal heated needle therapy can effectively alleviate the pain symptoms in patients with fibromyalgia syndrome and has a better clinical effect than oral amitriptyline alone.