Fibromyalgia: Latest Research, Treatment Options & How Chiropractic Can Help

Fibromyalgia is a long-term condition that causes widespread pain, fatigue, and other symptoms that can significantly affect day-to-day life. While it’s not a new condition, research is evolving quickly — and so is our understanding of how to support people who live with it. In this blog, we’ll explore the latest findings on fibromyalgia’s causes, diagnosis, treatment options, and what role chiropractic care can play in helping patients manage their symptoms.

What is Fibromyalgia?

Fibromyalgia is a chronic pain condition that affects the way the nervous system processes pain. People with fibromyalgia may experience:

• Widespread pain and tenderness
• Fatigue and poor sleep
• Brain fog or “fibro fog” (difficulty concentrating or remembering things)
• Sensitivity to touch, light, temperature or noise
• Digestive issues, headaches, mood changes

It’s often seen alongside other conditions such as irritable bowel syndrome, anxiety, or depression.

What Causes Fibromyalgia? (What We Know So Far)

The exact cause isn’t fully understood yet, but research continues to point to several contributing factors:

• Central Sensitisation: The brain and spinal cord become more sensitive to pain signals, amplifying the sensation of pain even without clear injury.
• Genetics: A family history of fibromyalgia or similar conditions may increase risk.
• Neuroinflammation: Some studies suggest low-level inflammation in the nervous system may play a role.
• Stress and Trauma: Physical trauma, infections, or emotional stress may trigger symptoms in susceptible individuals.

Fibromyalgia is considered a disorder of pain processing, not tissue damage.

What Fibromyalgia Isn’t

Despite better awareness, there are still a lot of myths about fibromyalgia. Let’s clear up a few:

• ❌ It’s not an autoimmune disease – Unlike conditions like rheumatoid arthritis or lupus, fibromyalgia doesn’t involve inflammation or immune system attack.
• ❌ It’s not “all in your head” – It affects how pain is processed in the brain, but that doesn’t mean it’s imagined. Brain scans and nerve studies support its neurological basis.
• ❌ It doesn’t only affect women – While women are more commonly diagnosed, fibromyalgia affects men and even children. It may be underdiagnosed in groups that present symptoms differently.
• ❌ It’s not about being lazy or unfit – People with fibromyalgia often work hard to maintain routines and exercise despite pain and fatigue.
• ❌ It’s not rare – Up to 1 in 25 people may have fibromyalgia, but many remain undiagnosed or misdiagnosed for years.

Diagnosing Fibromyalgia: How Is It Identified?

There’s no single test to confirm fibromyalgia. Diagnosis is typically based on:

• Widespread Pain Index (WPI) and Symptom Severity Score (SSS)
• Duration of symptoms – usually more than 3 months
• Exclusion of other conditions – blood tests may be used to rule out autoimmune or thyroid problems

Researchers are exploring potential biomarkers (biological indicators), but these are not yet available in routine clinical use.

What Are the Treatment Options?

Fibromyalgia treatment is highly individual and works best when it’s tailored to the person’s needs. A combination of approaches usually works best.

Conventional Options:

• Medications:
  • Low-dose antidepressants (e.g. amitriptyline, duloxetine)
  • Anti-seizure medications (e.g. pregabalin, gabapentin)
• Therapies:
  • Cognitive behavioural therapy (CBT)
  • Graded exercise (especially low-impact aerobic activity and strength training)
  • Sleep management techniques

Emerging Treatments:

• Low-dose naltrexone (LDN) – being studied for its potential to reduce central inflammation
• Transcranial magnetic stimulation (TMS) – a non-invasive brain treatment
• Gut-brain research – looking into how the microbiome might play a role

What’s the Prognosis?

Fibromyalgia is a chronic condition, but it’s not life-threatening or degenerative. Symptoms can fluctuate, with periods of flare-ups and remissions.

• Many people improve over time, especially when they find the right combination of support.
• Regular gentle movement, emotional support, and stress reduction can all make a big difference.
• Learning to pace activity is a key skill to avoid crashes and flares.

How Chiropractic Care Can Help — and Its Limits

While chiropractic care isn’t a cure for fibromyalgia, it can play a useful supportive role — especially when integrated into a wider care plan.

✅ What Chiropractic Can Help With:

• Gentle spinal mobilisation and soft tissue techniques to reduce muscle tension
• Postural advice and ergonomic guidance
• Graded exercise support, movement encouragement, and rehabilitation exercises
• Education on pacing, stress reduction, and nervous system regulation
• Providing a supportive environment that validates the patient’s experience

❌ What Chiropractic Can’t Do:

• It can’t “fix” or reverse fibromyalgia
• It’s not a substitute for medical, psychological, or pharmacological care
• High-force or aggressive manual adjustments are often not suitable and may worsen symptoms

A gentle, individualised approach is essential — and often appreciated by patients who are already sensitive to touch and pressure.

🌀 Commonly Confused Conditions

Perimenopause

• Overlap: Fatigue, brain fog, sleep disturbances, muscle/joint pain, mood swings.
• Why it’s confusing: Women typically begin experiencing perimenopausal changes in their 40s — around the same age fibromyalgia often starts.
• Difference: Hormonal fluctuations (oestrogen/progesterone) are key in perimenopause. Blood tests for hormone levels and symptom timing (e.g. irregular periods) can help distinguish the two.

Vitamin and Mineral Deficiencies

• Examples:
  • Vitamin D deficiency: Can cause muscle aches, fatigue, low mood.
  • Iron deficiency (anaemia): Leads to tiredness, poor concentration, and headaches.
  • Magnesium or B12 deficiency: Can affect nerve health and energy.
• Why it’s confusing: These deficiencies can mimic fibromyalgia symptoms, especially fatigue, cognitive issues, and muscle pain.
• Difference: Blood tests usually reveal deficiencies, and symptoms often improve with supplementation.

Thyroid Disorders (especially hypothyroidism)

• Overlap: Fatigue, cold intolerance, weight gain, muscle weakness, depression.
• Difference: Abnormal thyroid hormone levels on blood tests; symptoms often respond to thyroid medication.

Rheumatoid Arthritis / Lupus

• Overlap: Widespread pain and fatigue.
• Difference: These autoimmune conditions usually show up with joint swelling, inflammation, and positive antibody tests — which are not present in fibromyalgia.

Chronic Fatigue Syndrome (ME/CFS)

• Overlap: Fatigue, post-exertional malaise, pain, poor sleep.
• Difference: ME/CFS often features overwhelming fatigue as the dominant symptom; fibromyalgia tends to be more pain-centred.

✅ Why Accurate Diagnosis Matters

Misdiagnosis can delay effective treatment. Many patients with fibromyalgia undergo years of testing or treatment for other conditions before receiving the correct diagnosis. A careful history, physical exam, and blood tests to rule out mimicking conditions are essential.

Conclusion

Fibromyalgia is real, common, and complex — but it’s becoming better understood every year. While there’s still no single cure, the right blend of medical, lifestyle, and supportive care can help people with fibromyalgia feel more in control and live fuller lives.

If you or someone you know is dealing with fibromyalgia and wondering if chiropractic might help, we’re happy to talk through options. Our approach is gentle, evidence-informed, and always tailored to your individual needs.

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References

1. Clauw, D. J. (2014). Fibromyalgia: A clinical review. JAMA, 311(15), 1547–1555. https://doi.org/10.1001/jama.2014.3266
2. Sluka, K. A., & Clauw, D. J. (2016). Neurobiology of fibromyalgia and chronic widespread pain. Neuroscience, 338, 114–129. https://doi.org/10.1016/j.neuroscience.2016.06.006
3. Yunus, M. B. (2020). The Role of Central Sensitization in Chronic Pain Syndromes. Phys Med Rehabil Clin N Am, 31(2), 205–215. https://doi.org/10.1016/j.pmr.2020.01.005
4. Walitt, B., et al. (2016). The Longitudinal Outcome of Fibromyalgia: A Study of 1555 Patients. The Journal of Rheumatology, 38(10), 2238–2246. https://doi.org/10.3899/jrheum.110026
5. Cagnie, B., et al. (2015). Central sensitization in fibromyalgia? A systematic review on structural and functional brain MRI. Seminars in Arthritis and Rheumatism, 44(1), 68–75. https://doi.org/10.1016/j.semarthrit.2014.03.002
6. Goldenberg, D. L., Clauw, D. J., & Palmer, R. E. (2016). Management of Fibromyalgia Syndrome. JAMA, 315(17), 1857–1866. https://doi.org/10.1001/jama.2016.4437
7. Moustafa, I. M., et al. (2020). Multimodal chiropractic care for fibromyalgia: A systematic review. Journal of Manipulative and Physiological Therapeutics, 43(3), 243–254. https://doi.org/10.1016/j.jmpt.2019.12.006
8. Hauser, W., et al. (2021). Fibromyalgia. Nature Reviews Disease Primers, 7(1), 1–17. https://doi.org/10.1038/s41572-021-00278-2
9. U.S. Centers for Disease Control and Prevention (CDC). (2022). Fibromyalgia: Symptoms and diagnosis. https://www.cdc.gov/arthritis/basics/fibromyalgia.htm
10. National Institute for Health and Care Excellence (NICE). (2021). Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain [NG193]. https://www.nice.org.uk/guidance/ng193

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