Every year on May 12, the world comes together to recognize World Fibromyalgia Awareness-dedicated to shedding light on a condition that millions suffer from silently.
Fibromyalgia is often called an “invisible illness” because those affected may look well on the outside, while battling widespread pain, fatigue, and neurological symptoms on the inside.
As a neurologist and neurosurgeon, I frequently encounter patients whose lives have been disrupted by chronic pain syndromes, especially fibromyalgia.
Many are misdiagnosed or misunderstood for years. This article is an effort to explain fibromyalgia from a neurological point of view, highlight the latest research, and offer hope and guidance to those affected.
Read more : How a Brain and Spine clinic can Help with chronic Back pain
What Is Fibromyalgia?
Fibromyalgia is a chronic neurological disorder characterized by:
Widespread musculoskeletal pain
ㆍFatigu
ㆍSleep disturbances
ㆍCognitive issues (“fibro fog”)
ㆍHeightened sensitivity to pain (hyperalgesia)
ㆍMood disturbances like anxiety and depression
The condition affects approximately 2–4% of the global population, predominantly women (80–90% of cases), though men and children are not immune.
Read more :Neurological disorders in children Early detection and Intervention
Why Is It Called a Neurological Disorder?
Recent studies show that fibromyalgia involves abnormal pain processing in the central nervous system (CNS)—the brain and spinal cord. Functional MRI (fMRI) and PET scans reveal that people with fibromyalgia have overactive pain receptors and altered neurotransmitter activity.
In simple terms:
ㆍNormal pain signals are amplified.
ㆍThe brain perceives pain more intensely than it should.
ㆍEven mild stimuli—like pressure from clothing—may trigger discomfort.
That’s why fibromyalgia is not just a muscular problem, but a neurological one involving the pain-regulating centers of the brain.
Dr. Ganesh Veerabhadraiah
Consultant – Neurosurgeon, Neurointerventional Surgery, Spine Surgeon (Neuro)
23+ Years Experience Overall (17+ years as Neuro Specialist)
Available for Consultation: Jayanagar 9th Block & Kauvery Hospital, Electronic City
Symptoms That Often Go Unnoticed
Patients with fibromyalgia may experience a wide range of symptoms beyond pain:
1. Fatigue – Persistent tiredness, even after full rest.
2. Sleep disturbances – Light, non-restorative sleep with frequent awakenings.
3. Cognitive dysfunction (“Fibro fog”) – Memory lapses, difficulty concentrating, and slowed thinking.
4. Sensitivity to light, sound, or touch
6. Tingling or numbness in hands and feet
7. Jaw pain (TMJ disorders)
8. Irritable bowel syndrome (IBS)
9. Migraine and chronic headaches
10.Depression and anxiety
These symptoms often mimic or overlap with other disorders, leading to delays in diagnosis.
Read more :How to sleep better with Lower Back Pain
How to Protect Your Brain from Hypertension
1. Know Your Numbers
2.Follow Your Treatment Strictly
3. Adopt a Brain-Friendly Lifestyle
a) Diet
b) Exercise
c) Sleep & Stress
4. Limit Alcohol and Quit Smoking
• Smoking stiffens arteries and doubles stroke risk Special Tips for Elderly Patients
Key Takeaways
What Causes Fibromyalgia?
The exact cause is unknown, but several triggers and contributing factors have been identified:
• Genetic predisposition – It tends to run in families.
• Stress or trauma – Physical injury, emotional abuse, or surgery may act as triggers.
• Infections – Viral illnesses like Epstein-Barr or flu.
• Central sensitization – A key theory where the CNS becomes hypersensitive to stimuli.
• Sleep abnormalities – Poor sleep worsens pain perception.
• Hormonal imbalances – Altered levels of serotonin, dopamine, and norepinephrine.
How Is It Diagnosed?
Fibromyalgia is a clinical diagnosis—meaning there is no single test to confirm it. Diagnosis involves:
• A detailed history and symptom assessment
• Ruling out other conditions like hypothyroidism, lupus, or rheumatoid arthritis
• Checking for widespread pain in at least 4 of 5 pain regions, lasting more than 3 months
• Evaluating severity of fatigue, sleep, and cognitive symptoms
Many patients go through multiple specialists before receiving a correct diagnosis, often being mislabelled with psychological issues.
A Neurologist’s Approach to Fibromyalgia
As a neurologist, I focus on identifying the CNS dysregulation and differentiating fibromyalgia from other neurologic or musculoskeletal disorders. Our role involves:
• Excluding neuropathies, myopathies, multiple sclerosis, and chronic fatigue syndrome
• Evaluating nerve conduction studies and MRI scans (if needed)
• Managing associated migraines, restless leg syndrome, or seizures
• Addressing cognitive symptoms like brain fog with strategies to improve focus
Importantly, neurologists validate the patient’s experience, countering the harmful myth that “it’s all in your head.”
Treatment: Multimodal and Personalized
There is no permanent cure, but fibromyalgia is manageable with the right combination of strategies:
1.Medications
• Neuromodulators: Pregabalin, Gabapentin
• Antidepressants: Duloxetine, Amitriptyline (work on pain and mood)
• Muscle relaxants: Cyclobenzaprine
• Sleep aids: Melatonin or low-dose amitriptyline
• Pain relievers: Paracetamol, but avoid opioids (ineffective long-term)
2.Physical Therapy & Exercise
• Gentle aerobic exercises like walking, swimming, yoga
• Stretching and low-impact resistance training
• Regular movement reduces stiffness and boosts endorphins
3.Psychological Support
• Cognitive Behavioral Therapy (CBT) to manage stress, pain perception
• Mindfulness, meditation, guided relaxation
• Addressing anxiety and depression early is crucial
4. Lifestyle Adjustments
• Regular sleep schedule – aim for deep restorative sleep
• Balanced diet – anti-inflammatory foods, less sugar/caffeine
• Stress reduction – breathing exercises, journaling, therapy
5.Complementary Therapies
• Acupuncture
• Chiropractic care
• Massage therapy
• Biofeedback
While not curative, many patients report relief with these approaches.
What Patients Must Know
1.It’s Real
Your pain is real, even if not visible in scans. You are not imagining it.
2. It’s Neurological
The problem lies in how your brain processes pain, not just in the muscles.
3. It Takes Time
Managing fibromyalgia is a long-term journey, not a quick fix.
4. Support Is Vital
You need a care team, including neurologists, physiotherapists, psychologists, and family support.
5. You Can Lead a Full Life
With the right management, many patients return to work, travel, exercise, and enjoy their life again.
Fibromyalgia and the Indian Context
In India, fibromyalgia is underdiagnosed. Many people, especially women, are told to “ignore it,” “adjust,” or blamed for “overreacting.” Cultural stigma worsens their suffering.
Awareness among physicians and the public is improving, but more education, empathy, and access to multidisciplinary care is needed.
When to See a Neurologist Consult a neurologist if:
• Pain persists despite medication and normal tests
• You have numbness, tingling, or weakness
• Cognitive symptoms interfere with work or life
• There is concern about stroke, epilepsy, or MS
• You want a confirmed diagnosis and plan
Message about Fibromyalgia
Fibromyalgia may not leave visible scars, but it deeply affects lives. On this World Fibromyalgia Awareness Day, let’s pledge to:
• Listen to those who suffer silently
• Educate others about this complex neurological condition
• Support research and advocacy
• Empower patients with compassion and science
If you or someone you know lives with fibromyalgia, know this: you are not alone, and help is available. Let’s work together to ease the burden and restore hope—one step at a time.
FAQs:
1. What is fibromyalgia?
Fibromyalgia is a chronic neurological disorder marked by widespread pain, fatigue, sleep issues, and cognitive difficulties, affecting 2–4% of the population.
2. Why is fibromyalgia called a neurological condition?
Because it involves abnormal pain processing in the brain and spinal cord, not just muscular issues.
3. What are the common symptoms of fibromyalgia?
Symptoms include chronic pain, fatigue, sleep disturbances, “fibro fog,” heightened sensitivity, migraines, and mood changes.
4. How is fibromyalgia diagnosed?
There is no single test. Diagnosis is based on symptoms, ruling out other conditions, and assessing widespread pain lasting more than 3 months.
5. Can fibromyalgia be cured?
There’s no permanent cure, but fibromyalgia is manageable with medications, physical therapy, psychological support, and lifestyle changes.
6. When should I see a neurologist for fibromyalgia?
If symptoms persist, interfere with life, or involve numbness or cognitive problems, a neurologist can help confirm diagnosis and guide treatment.
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