Fibromyalgia is one of the hardest problems in all of medicine

• Jan 5, 2021 • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of PainScience.com: a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

I often get asked how to treat fibromyalgia, which is basically like asking me how to solve one of the hardest problems in all of medicine. We’ll probably figure out how to handle Alzheimer’s and rheumatoid arthritis before fibromyalgia. So, please, do go easy on yourself if you’re unsure how to manage unexplained chronic widespread pain. It’s okay! No one actually knows!

Naturally, there are people who claim to know. They truly don’t. There are some good ideas, and some of those ideas pan out for some patients, some of the time. But this is a beast with many and diverse heads, and we should definitely not trust anyone who claims to have mastered it.

As always, remember that “fibromyalgia” is not a diagnosis — it’s a label for a pattern of distinctive but unexplained symptoms, which almost certainly have at least several different causes. Fibromyalgia isn’t one specific disease anymore than cancer is, and it isn’t even a category of pathology defined by a specific mechanism like cancer.