Fibromyalgia

Fibromyalgia is a chronic pain syndrome marked by widespread pain, fatigue, non-restorative sleep, and cognitive symptoms such as slowed concentration or “fibro fog.” The pain is real, but it is not explained by ongoing destruction of muscle or joint tissue. The leading model is central sensitization. Pain-processing pathways in the spinal cord and brain become overly responsive, so ordinary sensory input is interpreted as painful or more painful than expected. Dysregulation of serotonin, norepinephrine, and glutamate pathways is thought to contribute. Poor sleep and fatigue then lower the threshold for symptom flares, creating a self-reinforcing pain–sleep–fatigue cycle. This mechanism explains why a patient may report severe pain despite no swollen joints, no focal neurological lesion, and no diagnostic abnormality on routine testing. It does not mean the symptoms are psychological or imagined. Mood disorders, stress, and sleep disorders may coexist and amplify disability, but they do not invalidate the pain experience.