Fibromyalgia

N Engl J Med. 2026 Jul 16;395(3):267-277. doi: 10.1056/NEJMcp2411656.

Abstract

Fibromyalgia is characterized by widespread pain involving any body tissue and typically accompanied by fatigue and problems with sleep, mood, and memory. Fibromyalgia can occur alone or in combination with other chronic overlapping primary pain conditions, or it can be superimposed on other conditions, such as autoimmune disorders (secondary pain). In fibromyalgia, the central nervous system (CNS) is hyperresponsive to sensory stimuli generally. Successful pharmacologic and nonpharmacologic interventions focus on the CNS to support CNS quiescence and a return to homeostasis. Although fibromyalgia is rarely curable, most cases can be well managed in the context of primary care.

Publication types

  • Review

MeSH terms

  • Analgesics / therapeutic use
  • Antidepressive Agents, Tricyclic / therapeutic use
  • Central Nervous System / physiopathology
  • Chronic Pain* / complications
  • Chronic Pain* / diagnosis
  • Chronic Pain* / physiopathology
  • Chronic Pain* / therapy
  • Cognitive Behavioral Therapy
  • Depression / epidemiology
  • Depression / etiology
  • Depression / psychology
  • Depression / therapy
  • Exercise Therapy
  • Fatigue / epidemiology
  • Fatigue / etiology
  • Fatigue / physiopathology
  • Fatigue / therapy
  • Fibromyalgia* / complications
  • Fibromyalgia* / diagnosis
  • Fibromyalgia* / physiopathology
  • Fibromyalgia* / therapy
  • Humans
  • Pain Management* / methods
  • Pain Management* / standards
  • Pain Perception / physiology
  • Patient Education as Topic
  • Practice Guidelines as Topic
  • Prevalence
  • Quality of Life
  • Self Care / methods
  • Serotonin and Noradrenaline Reuptake Inhibitors / therapeutic use
  • Sleep Wake Disorders / epidemiology
  • Sleep Wake Disorders / etiology
  • Sleep Wake Disorders / physiopathology
  • Sleep Wake Disorders / therapy

Substances

  • Antidepressive Agents, Tricyclic
  • Serotonin and Noradrenaline Reuptake Inhibitors
  • Analgesics