Fibromyalgia

Fibromyalgia is a chronic syndrome of widespread musculoskeletal pain accompanied by fatigue, unrefreshing sleep, memory and concentration problems and heightened sensitivity to pressure.

It is thought to involve altered pain processing in the central nervous system rather than damage to the muscles or joints themselves. Symptoms often begin after physical or emotional stress, infection or injury, and they fluctuate over time. Headaches, irritable bowel symptoms, depression and anxiety frequently coexist, and the condition is more common in women and in people with rheumatic diseases.

There is no confirmatory test; diagnosis follows criteria based on widespread pain lasting at least three months and symptom severity, after excluding other causes with examination and blood work. Established management combines exercise, sleep strategies, cognitive behavioral therapy and certain medications. A randomized placebo-controlled trial of cannabidiol in fibromyalgia did not show a pain benefit over placebo, so analgesic claims are not supported.