Does Transcranial Magnetic Stimulation Help Fibromyalgia?

What is Transcranial Magnetic Stimulation and does it Help Fibromyalgia?

Transcranial Magnetic Stimulation (TMS) is a non-invasive therapy that uses magnetic fields to stimulate nerve cells in the brain. It’s most commonly used to treat depression, but research shows it may also help with chronic pain conditions like fibromyalgia.

How It Works

• A device with an electromagnetic coil is placed against your scalp.

• It sends magnetic pulses into specific areas of your brain—usually the motor cortex or prefrontal cortex.

• These pulses activate neurons and can help regulate brain activity linked to pain perception, mood, and fatigue.

A magnetic coil is positioned on the patient's head. IMAGE: Baburov

Types of TMS

• Repetitive TMS (rTMS): Delivers pulses in rapid succession. This is the most studied form for fibromyalgia.

• Deep TMS: Reaches deeper brain structures and is used for more complex conditions.

For Fibromyalgia

Studies suggest rTMS may:

• Reduce pain intensity

• Improve quality of life

• Ease fatigue, anxiety, and depression

• Offer relief lasting weeks after treatment

It’s typically done in a clinic, with sessions lasting around 30–40 minutes, several times a week for a few weeks.

Transcranial Magnetic Stimulation (TMS), specifically repetitive TMS (rTMS), is emerging as a promising non-invasive therapy for fibromyalgia. Using magnetic pulses to stimulate targeted areas of the brain, rTMS may help modulate pain perception and improve mood—two major challenges for people living with fibromyalgia.

New Research:

rTMS Shows Pain Relief and Quality of Life Improvements

A 2022 study published by the National Institutes of Health found that rTMS significantly relieved pain and enhanced quality of life in fibromyalgia patients. This supports growing clinical interest in using brain stimulation to manage chronic pain conditions.

More Than Just Pain Relief:

rTMS Reduces Anxiety, Depression, and Fatigue

A 2025 study published in SpringerOpen reported that rTMS not only reduced pain, but also lowered anxiety, depression, and fatigue levels in fibromyalgia patients. These findings suggest that rTMS may offer a more holistic benefit, targeting both physical and emotional symptoms.

Functional Gains:

Improved Function and Lasting Effects

According to Neuralia TMS, a 2018 study in the Journal of Pain Research showed that TMS effectively reduced pain and improved function in people with fibromyalgia. Another study published on ScienceDirect in 2025 found that pain relief from rTMS lasted up to 8 weeks post-treatment, with an excellent effect size.

Real-World Therapy:

What Clinics Are Saying

Smart TMS reports that studies consistently show rTMS relieves pain and enhances quality of life for fibromyalgia patients. Beyond pain relief, TMS also appears to reduce fatigue and improve emotional well-being.

So, Does TMS Help?

The evidence is stacking up: rTMS may be a powerful tool in the fibromyalgia treatment arsenal. It’s non-invasive, drug-free, and shows promise in reducing pain, fatigue, and mood-related symptoms. While more large-scale trials are needed, current research suggests that TMS could offer meaningful relief for many fibro patients.

Have you tried TMS therapy? Did it help your fibromyalgia symptoms? Share your experience below—we’d love to hear from real people living with fibro.

Disclaimer: I am not a medical professional, and I am not recommending any specific treatment. I have not personally tried these therapies. This article is for informational purposes only and is based on published research. Always consult with a qualified healthcare provider before starting any new treatment. Different approaches work for different people, and what helps one person may not help another.

Sources: 

Oxford Academic  –rTMS for Fibromyalgia

SpringerOpen 

Neuralia TMS 

Smart TMS 

Neurotherapeutics

You might also like to read:

• 36 things to try when you have Fibromyalgia
• My experiences with starting hydrotherapy for fibromyalgia
• Keeping my house clean when chronically ill

Things to Try When You Have Fibromyalgia

36 things to try when you have Fibromyalgia.

Fibromyalgia is a complex condition that affects every part of life—pain, fatigue, sleep, mood, and cognition. While there’s no universal fix, there are many strategies that can help you feel better, function more fully, and reclaim your energy. Here’s a comprehensive list of things to try, backed by research and real-life experience.

1. D-Ribose

This naturally occurring sugar helps fuel your cells. Studies by Dr. Jacob Teitelbaum showed energy boosts of 45–61% in fibromyalgia and chronic fatigue patients. Available as a supplement, many find it improves stamina and mental clarity.

2. Palmitoylethanolamide (PEA)

PEA is a fatty acid amide that supports the endocannabinoid system and may reduce pain and inflammation. It’s available over the counter and has shown promise in chronic pain conditions including fibromyalgia.

3. Low Dose Naltrexone (LDN)

Originally used to treat addiction, LDN at low doses may help regulate the immune system and reduce pain sensitivity. Many fibro patients report improved sleep and reduced flare-ups.

4. Myofascial Massage

This gentle, sustained-pressure technique targets connective tissue and muscle knots. It can relieve pain, improve mobility, and reduce tension without triggering post-massage soreness.

5. Reflexology

By stimulating pressure points on the feet, reflexology may help balance the nervous system and reduce pain perception. It’s a relaxing, non-invasive therapy worth trying.

6. Allergy Testing

Hidden food sensitivities or environmental allergies can exacerbate fibro symptoms. Identifying and eliminating triggers may reduce inflammation and fatigue.

7. Hydrotherapy

Moving in warm water can improve circulation, reduce stiffness, and ease pain.

8. Hyperbaric Oxygen Therapy (HBOT)

HBOT involves breathing pure oxygen in a pressurized chamber. Some studies suggest it may reduce fibro pain and improve cognitive function by enhancing tissue oxygenation.

 9. Aerobic Exercise

Gentle aerobic activity (walking, swimming, cycling) 2–3 times a week can improve pain, fatigue, and mood. Start slow, increase gradually, and expect some short-term discomfort before long-term gains.

10. Strength Training

Light resistance training can help combat fatigue and improve muscle tone. Combine with endurance exercises for best results.

11. Mindfulness & Meditation

Practicing mindfulness can help reduce stress, improve pain tolerance, and calm the nervous system. Even 10 minutes a day can make a difference.

12. Exergaming

Video games that involve movement—like Wii Fit or VR fitness—can be a fun, low-impact way to stay active and engaged.

13. Whole-Body Vibration

Using vibration platforms alongside traditional exercise may reduce fatigue and improve physical function. See trial results here. 

14. Balneotherapy

Soaking in mineral-rich baths—like Epsom salts or hot springs—can soothe pain and boost energy.

15. Sleep Hygiene

Better sleep = better everything. Stick to a routine, avoid stimulants before bed, and create a calming sleep environment.

16. Raw Vegetarian Diet

A mostly raw plant-based diet may help reduce fatigue and inflammation. Think fresh veggies, fruits, nuts, and seeds.

17. TENS Units

These portable devices deliver electrical pulses to relieve pain and fatigue. Affordable and widely used.

18. Transcranial Magnetic Stimulation

Noninvasive brain stimulation that may reduce fatigue and improve mood. Read the research about TMS. 

19. Electroconvulsive Therapy

Though controversial, ECT has helped some patients with severe fatigue and depression.

20. Cortical Electrostimulation

Another brain-based therapy showing moderate improvement in fatigue.

21. Sensory Motor Rhythm Treatment

A neurofeedback technique that helps regulate brain activity and reduce fatigue.

22. Low-Energy Laser Therapy

Mixed results for fatigue, but promising for pain relief.

23. Pulsed Ultrasound & Interferential Current

These therapies may help with morning fatigue and muscle stiffness.

24–30. Medications That May Help

Some prescription drugs have shown promise in reducing fatigue and improving quality of life:

• Duloxetine (Cymbalta)

• Milnacipran (Savella)

• Fluoxetine (Prozac)

• GHB/Sodium Oxybate (Xyrem)

• Pramipexole (Mirapex)

• Quetiapine (Seroquel)

• Raloxifene (Evista)

31. Acetyl L-Carnitine

An amino acid supplement that may improve mental clarity and energy.

32. Pacing & Planning

Use the “energy envelope” approach—plan your day around your energy levels to avoid crashes. Prioritize, delegate, and rest before you’re exhausted. Find out more about pacing here.

33. Multidisciplinary Care

Work with a team—rheumatologists, physiotherapists, psychologists—to address all aspects of fibromyalgia. A holistic approach often yields better results.

34. Yoga

Gentle yoga sequences tailored for chronic illness can ease pain, fatigue, and depression. It’s a calming way to reconnect with your body.

35. Acupuncture

A course of acupuncture treatment has been proven many times to significantly help reduce the pain of fibromyalgia. 

36. The Guaifenesin Protocol for fibromyalgia

It is a strict dietary restriction of salicylates and the use of guaifenesin, an expectorant medication. Some people say this cuts their fibromyalgia pain a lot. 

What’s your go-to strategy for managing fibromyalgia fatigue? Is it on the list? Share your tips in the comments and help others find relief!

Disclaimer: I am not a medical professional, and I am not recommending any specific treatment. I have personally only tried some of these therapies. This article is for informational purposes only and is based on published research. Always consult with a qualified healthcare provider before starting any new treatment. Different approaches work for different people, and what helps one person may not help another.

Amazon Affiliate Disclaimer: Some of the links in this post are Amazon affiliate links, which means I may earn a small commission if you buy something through them—at no extra cost to you. I only share products I think might be useful or interesting, but please do your own research before making a purchase. Thanks for supporting the site!

Fibromyalgia and the Eyes: What We’re Finally Starting to See

 

For many of us living with fibromyalgia, the list of symptoms feels endless—and often invisible. Pain, fatigue, brain fog, sensory overload. But what if some of the discomfort we feel isn’t just neurological or muscular… but ocular?

A new study published in Rheumatology International has confirmed what many of us have long suspected: people with fibromyalgia have significantly higher rates of astigmatism, dry eye disease (DED), and meibomian gland dysfunction (MGD) compared to those without FMS. You can read the full article here. 

What the Study Found

Researchers in Turkey conducted a cross-sectional analysis of fibromyalgia patients and healthy controls. While visual acuity and eye pressure were similar between groups, the FMS group showed:

• Higher astigmatism in both eyes

• 36.6% prevalence of MGD (vs. 4.3% in controls)

• 60.6% prevalence of DED (vs. 21.4% in controls)

These findings suggest that ocular symptoms may be part of the fibromyalgia landscape, not just coincidental complaints.

Why This Matters

Many of us experience:

• Blurred vision

• Light sensitivity (photophobia)

• Eye pain or dryness

• Trouble reading or focusing visually

These symptoms are often dismissed or misattributed. But this research points to autonomic nervous system dysfunction and immune system involvement as possible culprits—both of which are central to fibromyalgia.

It’s not “just in your head.” It’s in your eyes, too.

Connecting the Dots: Irlen Syndrome, Astigmatism, and Sensory Processing

Some in the chronic illness and neurodivergent communities have wondered aloud: could there be a link between fibromyalgia and Irlen Syndrome—a visual processing condition that causes distortions, headaches, and light sensitivity?

While Irlen isn’t an eye disorder per se, it overlaps with many fibro-related symptoms. And with this new data on astigmatism and dry eye, the connection feels worth exploring. Could sensory dysregulation be the thread that ties these experiences together?

What You Can Do

• Ask for a full ocular assessment—especially if you experience visual discomfort

• Track your symptoms and bring them to your provider with language like: “I’ve read that fibromyalgia may increase risk for dry eye and astigmatism. I’d like to explore this further.”

• Consider tinted lenses or overlays if you suspect Irlen-like symptoms

• Validate your experience—even if no one else has named it yet

Fibromyalgia is more than pain. It’s a multisystem condition that affects how we see, feel, and move through the world. This study is one more step toward recognition—and one more reason to trust your body’s signals.

If you’ve felt like “one of those people who has everything and a lot more,” you’re not alone. You’re part of a community that’s finally being seen.

You may be interested in my previous post on The Eyes and Fibromyalgia which explains some ways to reduce eye symptoms and has interesting information from people with these issues in the comments section. 

You might also like to read:

• Do you allow yourself to ask for support?
• Self care strategies that help me manage pain
• Natural treatments for fibromyalgia

Fibromyalgia is a Functional Pain Syndrome

Until recently, I hadn't heard of the term FPS, which stands for Functional Pain Syndrome. So I looked it up, and here's what I found:

When someone is in pain but doctors can’t find a clear physical cause, it’s often called functional pain. The diagnosis depends on where the pain is felt — for example, in the stomach for people with Irritable Bowel Syndrome (IBS) or in the muscles and joints for those with Fibromyalgia (FM).

Experts are now changing how they think about FPS. Instead of seeing each chronic pain condition as separate, they’re starting to group them under a broader idea called Central Sensitivity Syndrome (CSS). This means that the brain and nervous system are more sensitive to pain signals.

Fibromyalgia is one type of FPS.

Fibromyalgia is a type of Functional Pain Syndrome, which means it causes real pain even though doctors can't find a clear injury or damage in the body.

In my opinion, it would be very helpful if doctors could tell us something about a brand-new pain we are experiencing - is it caused by Fibromyalgia or by something else? Is it just fibromyalgia that just feels different or is showing up in a new area? Is it relted to something completely different and not fibromyalgia? But fibro does not seem to work like that. It is not clear cut and cannot be seen in any blood tests or xrays etc. 

People with fibromyalgia often feel pain from things that wouldn’t bother most people — like a light touch. This is likely because their nervous system has become overly sensitive, a process known as central sensitization.

What is perceived as touch in an individual from the general population is perceived as pain in individuals suffering from FM. This is probably due to their central sensitization.  

Dr David Crabtree & Dr Praveen Ganty 

Central sensitization means the brain and spinal cord react too strongly to pain signals. This happens because of a complicated mix of chemicals in the body that either increase or decrease pain. This might also explain why people with fibromyalgia often feel tired, have memory issues, and struggle with sleep and mood problems.

How does knowing all this help me (I can here you asking)

Knowing that fibromyalgia is a Functional Pain Syndrome can be really comforting and helpful, especially when you're trying to make sense of what’s going on with your body.

It means:

💡 Your pain is real.
Even if tests come back normal, what you’re feeling isn’t "in your head." Your nervous system is just working differently and that’s something good doctors now understand better.

🧭 You’re not alone.
There are many others living with the same condition. It has a name, it has patterns, and there are communities and support out there.

🌱 There are ways to feel better.
Once doctors know what’s really going on, they can focus on treatments that actually help like managing stress, improving sleep, gentle movement, and sometimes medications that calm the nervous system.

❤️ It’s not your fault.
You didn’t cause this. Your brain and body are reacting in a certain way, and now that there’s a clearer understanding of why, you can be kinder to yourself and more hopeful moving forward.

These sources go into more depth if you want to explore the science or treatment options further: 

1. Mayo Clinic Proceedings – “Fibromyalgia: Understanding the Pathogenesis”
   https://www.mayoclinicproceedings.org/article/S0025-6196(15)00243-8/fulltext

2. ScienceDirect – “Neurobiology of central sensitization”
   https://www.sciencedirect.com/science/article/pii/S0306452216302366

3. Verywell Health – “Understanding Central Sensitivity Syndromes”
   https://www.verywellhealth.com/central-sensitivity-syndromes-716160

4. Cleveland Clinic Journal of Medicine (CCJM) – “Fibromyalgia and Central Sensitization Syndrome”
   https://www.ccjm.org/content/90/4/245

5. Common Functional Pain Syndromes                        https://www.bjaed.org/article/S2058-5349(17)30034-3/fulltext

Clinical trials into Fibromyalgia 2021

 August 13, 2021. 

Here is a 2021 list of some current trials into fibromyalgia, and related conditions, that are recruiting for participants in various parts of the world. As the byline of this blog is 'Discovering what works to help Fibromyalgia' it would be remiss of me to not include information about clinical trials into fibromyalgia. I have in fact posted about trials previously... Here is a post I did about them in 2020. 

Clinical trials can help us discover and confirm so many things about a condition -  it causes, connections, preventatives and treatments. 

My experience with Dandelion Coffee to help digestive issues

In this series I am investigating what foods can help heal our body or even just help reduce some of the challenges of chronic illness. As well as fibromyalgia I am diagnosed with autoimmune diseases, including Sjogren's syndrome.

Since my early 20's I have been interested in the healing power of what we eat. I studied, and have a diploma in, herbal medicine. 

Today I am writing about Dandelion Coffee and it's healing powers as it was brought to my attention in my facebook group that it is not well known. Considering it's amazing benefits and how it has helped me I thought I should highlight it here. 

DANDELION THE HERB
Dandelion (Taraxacum officinalis) is a Digestive Bitter Herb.

In traditional herbal medicine, dandelion root has long been used to treat stomach and liver conditions due to its purported ability to “detoxify” the blood and be a general tonic.

Element profile of Dandelion:  

Na 740  K 180  Li 78  Fe 19.5  Ca 106  Mg 6.4   Zn 2.32

It is rich in vitamins A, C, D, E, and B, inositol, lecithin, and minerals such as iron, magnesium, sodium, calcium, silicon, copper, phosphorus, zinc, and manganese.

Among vegetables, dandelion is one of the richest source of beta-carotene (11,000 µg/100 g leaves, same as in carrots), from which vitamin A originates.

In the past few years, dandelion has demonstrated health benefits including anti-rheumatic, anti-carcinogenic, diuretic, laxative, hypoglycemic, and chloretic effects.

Besides its use as a coffee substitute, the leaf extracts are known to have diuretic properties, which have now been confirmed scientifically, and be effective against obesity and cardiovascular disease.

Dandelion is on the FDA's list of safe foods.

Dandelion restores potassium rather than depleting it like conventional diuretics.

It promotes healthy digestive functioning.

It reduces pre-menstrual bloating caused by an excess of fluid build-up.

Dandelion (Taraxacum officinalis) is a Digestive Bitter Herb.

DIFFERENT TYPES OF DANDELION

Dandelion is available in the of coffee, tea, capsules, and tablets. In Australia, where I live, it is available from health stores and larger supermarkets. 

Dandelion coffee is made from the roasted roots and is known as a liver tonic and detoxifier. 

Dandelion tea is made from dried leaves and is known as a diuretic that helps the body excrete excess fluid through urination.

MY EXPERIENCE WITH DANDELION
I use to drink Dandelion root coffee many years ago as a university student. I enjoyed it and understood the many benefits due to having studied herbalism. 

I don't know why I stopped drinking it... probably due to the cost as I was not working and also I did not have any illnesses. 

I have remembered it recently when, added to my autoimmune conditions and fibromyalgia, I started having new digestive symptoms. I was rushing to the ER around every 3 months with severe stomach pain, nausea, vomiting and swollen belly. 

I underwent many tests including a colonoscopy and endoscopy and ultrasound of the stomach. It was discovered that I had gallstones and an enlarged liver. This was a shock to me as I have a fairly healthy diet with lots of vegetables, wholegrains and fruit. My big 'treat' was my daily coffee. 

I drink my dandelion coffee with soy milk or skim milk

I remembered dandelion coffee and so I replaced my coffee intake over 3 days with dandelion coffee. At first replacing one of my 2 daily coffees with dandelion coffee and them both. I was amazed that it was a fairly easy transition.

I love the taste of dandelion coffee and I am reaping the benefits:

• my daily morning nausea has disappeared completely.
• no visits to the ER since October with excruciating stomach pain.
• less daily bloating in my fingers and toes that use to prevent me from making a fist every night.

MY RECOMMENDED DANDELION COFFEE

Symingtons Instant Dandelion Coffee

Are you thinking of trying dandelion coffee after reading this article? Are you already drinking it and appreciate it's wonderful benefit? I would love to hear from you in the comments below.

SUMMARY OF THE BENEFITS OF DANDELION COFFEE

Dandelion coffee, made from roasted dandelion roots, is a caffeine-free herbal drink often used as a coffee substitute. It offers several potential health benefits:

1. Liver Support

• Dandelion root is known for its liver-detoxifying properties. It may help stimulate bile production, which supports digestion and liver function.

2. Digestive Aid

• Acts as a mild diuretic and laxative, promoting healthy digestion and regular bowel movements.

• Helps relieve bloating and indigestion.

3. Antioxidant Properties

• Contains antioxidants like beta-carotene and polyphenols, which help combat oxidative stress and may reduce inflammation.

4. Caffeine-Free Energy Boost

• Offers a similar taste and experience to coffee without the caffeine, which can be beneficial for people who are sensitive to stimulants or want to reduce their intake.

5. May Support Blood Sugar Control

• Some studies suggest dandelion root may help regulate blood sugar and improve insulin sensitivity, though more research is needed.

6. Rich in Nutrients

• Contains vitamins and minerals such as vitamin A, C, K, calcium, and iron, contributing to overall health.

7. Supports Kidney Function

• As a natural diuretic, it can help the body eliminate excess fluid, potentially benefiting kidney health and reducing water retention.

8. Anti-Inflammatory Effects

• May help reduce systemic inflammation, which is linked to many chronic conditions.

SOURCES FOR THIS ARTICLE

The Physiological Effects of Dandelion (Taraxacum Officinale) in Type 2 Diabetes. Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Tage-Hansens Gade 2, DK-8000 C, Denmark, 2016.

Elemental profile of 24 common medicinal plants of Pakistan and its direct link with traditional uses. Institute of Chemistry, University of the Punjab, Pakistan. Institute of Agricultural Sciences, University of the Punjab, Pakistan, 2011.

The Diuretic Effect in Human Subjects of an Extract of Taraxacum officinale Folium over a Single Day

Department of Herbal Medicine, Tai Sophia Institute, Laurel, MD.

2Massachusetts College of Pharmacy and Health Sciences, Boston, MA.

3National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD.

4

Department of Herbal Medicine, Tai Sophia Institute, Laurel, MD.

2Massachusetts College of Pharmacy and Health Sciences, Boston, MA.

3National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD.

4

Department of Herbal Medicine, Tai Sophia Institute, Laurel, MD.

2Massachusetts College of Pharmacy and Health Sciences, Boston, MA.

3National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD.

4

Department of Herbal Medicine, Tai Sophia Institute, Laurel, MD.

2Massachusetts College of Pharmacy and Health Sciences, Boston, MA.

3National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD.

4

Findings Link Gut Bacteria and Fibromyalgia

(Credit: Vladislav Muslakov/Unsplash)

POSTED BY JULIE ROBERT-MCGILL

There are alterations in the bacteria in the gastrointestinal tracts of people with fibromyalgia, report researchers.

Fibromyalgia affects 2-4 percent of the population and has no known cure. Symptoms include fatigue, impaired sleep, and cognitive difficulties, but the disease is most clearly characterized by widespread chronic pain.

“AS PAIN PHYSICIANS, WE ARE FRUSTRATED BY OUR INABILITY TO HELP…”

 As reported in the journal Pain, approximately 20 different species of bacteria were found in either greater or lesser quantities in the microbiomes of participants suffering from the disease than in the healthy control group.

“We used a range of techniques, including artificial intelligence, to confirm that the changes we saw in the microbiomes of fibromyalgia patients were not caused by factors such as diet, medication, physical activity, age, and so on, which are known to affect the microbiome,” says Amir Minerbi of the Alan Edwards Pain Management Unit at the McGill University Health Centre (MUHC), and first author of the paper.

“We found that fibromyalgia and the symptoms of fibromyalgia—pain, fatigue, and cognitive difficulties—contribute more than any of the other factors to the variations we see in the microbiomes of those with the disease,” Minerbi adds.

“We also saw that the severity of a patient’s symptoms was directly correlated with an increased presence or a more pronounced absence of certain bacteria—something which has never been reported before.”

At this point, it’s not clear whether the changes in gut bacteria seen in patients with fibromyalgia are simply markers of the disease or whether they play a role in causing it. Because the disease involves a cluster of symptoms, and not simply pain, the next step in the research will be to investigate whether there are similar changes in the gut microbiome in other conditions involving chronic pain, such as lower back pain, headaches, and neuropathic pain.

The researchers are also interested in exploring whether bacteria play a causal role in the development of pain and fibromyalgia. And whether their presence could, eventually, help in finding a cure, as well as speed up the process of diagnosis.

DIAGNOSIS SOONER?

Fibromyalgia has proved difficult to diagnose. Patients can wait as long as 4 to 5 years to get a final diagnosis. But this may be about to change.

“We sorted through large amounts of data, identifying 19 species that were either increased or decreased in individuals with fibromyalgia,” says Emmanuel Gonzalez, from the Canadian Center for Computational Genomics and the department of human genetics at McGill University.

“By using machine learning, our computer was able to make a diagnosis of fibromyalgia, based only on the composition of the microbiome, with an accuracy of 87 percent. As we build on this first discovery with more research, we hope to improve upon this accuracy, potentially creating a step-change in diagnosis.”

A FRUSTRATING DISEASE

“People with fibromyalgia suffer not only from the symptoms of their disease but also from the difficulty of family, friends, and medical teams to comprehend their symptoms,” says Yoram Shir, the senior author of the paper and the director of the Alan Edwards Pain Management Unit at the MUHC and an associate investigator from the BRaiN Program of the RI-MUHC.

“As pain physicians, we are frustrated by our inability to help, and this frustration is a good fuel for research. This is the first evidence, at least in humans, that the microbiome could have an effect on diffuse pain, and we really need new ways to look at chronic pain.”

The research was based on a cohort of 156 individuals in the Montreal area, 77 of whom suffer from fibromyalgia. Participants in the study participated in interviews and gave stool, blood, saliva, and urine samples, which researchers then compared with those of healthy control subjects, some of whom lived in the same house as the fibromyalgia patients or were their parents, offspring, or siblings.

The researchers’ next steps will be to see whether they get similar results in another cohort, perhaps in a different part of the world, and to do studies in animals to discover whether changes in bacteria play a role in the development of the disease.

Funding for the work came from the Louise and Alan Edwards Foundation and the Israeli Society for Musculoskeletal Medicine. The team also included researchers from McGill University and Université de Montréal, as well as others from the Research Institute of the MUHC.

Source: McGill University

You may also be interested in:

The causes of Fibromyalgia - latest theories (2025)

Upper Trapezius Changes Linked to Fibromyalgia

Identifying Fibromyalgia Biomarkers discovered

How can a doctor diagnose Fibromyalgia?

There is a lot of confusion around the diagnosis of Fibromyalgia. I personally have experienced this when I was seeking help for chronic stiffness and pain.

To keep things simple Fibromyalgia or Fibromyalgia Syndrome (FMS) is diagnosed by a doctor, nurse or other medical specialist when you have 11 or more tender points in SPECIFIC places on your body. (This way of diagnosing was current when I wrote this article. It has been superceded by the which you can find here. This does not mean that you will not have the tender points but they are no longer used as the definitive test for Fibromyalgia.)

The following is a diagram of these tender point spots. There are 18 in all and you must have soreness, on touch, in 11 or more to have a diagnosis. (Prior to 2010)



Fibromyalgia is now diagnosed according to criteria published by the American College of Rheumatology: widespread musculoskeletal pain and tenderness measured by the ‘tender point count’ on physical examination.

DIFFICULTY IN GETTING A DIAGNOSIS OF FIBROMYALGIA
There are many reasons why you may find it difficult to get a correct diagnosis.
Here are some I have encountered:

• FMS can exist at the same time as other medical conditions and these can also be pain conditions e.g. I have Polymyositis which is an autoimmune condition which causes weakness and pain in proximal muscles but I also have FMS as I have tender point pain in 11 places.

• There is no specific blood test for FMS.

• There’s no scan, or imaging that can confirm fibromyalgia.

• When blood work and imaging come back “normal,” some doctors may dismiss your symptoms or consider it psychological.

• Many medical specialists believe that fibromyalgia is all in the head and this can range from a variety of opinions from it doesn't exist to, it is due to depression, to it is due to changes in neurochemicals in the brain.

• One specialist told me that FMS is a diagnosis given to people in pain when they have not yet got a complete diagnosis.

• Because symptoms are invisible and vary day-to-day, they can be misunderstood or dismissed.

• FMS causes so many symptoms, not just pain, and the patient may not present with the pain as the other symptoms may be their immediate concern.

• Not all healthcare providers are fully trained or up-to-date on fibromyalgia.

• Some doctors diagnosis or mislabel it as stress, anxiety, or depression because these can all be a part of FMS.

• If you have coexisting conditions (e.g., arthritis or IBS), fibro may be overlooked.

• Symptoms need to be widespread and persistent for at least 3 months.

• A single appointment might not capture the full picture — it often takes multiple visits and tracking symptoms over time.

• Gender Bias

• Fibromyalgia affects more women than men so men may not be as easily diagnosed.

• Some studies show women’s pain is taken less seriously or written off as emotional, which can delay diagnosis.

• Communication Challenges

• Some people don’t realize how much their symptoms matter or may downplay them at appointments.

• Or, they struggle to find the right words to describe symptoms like "fibro fog" or "deep bone pain."

• Seeing the Wrong Specialist

  • Primary care doctors might refer you to rheumatologists, neurologists, endocrinologists, etc.

  • If none see the whole picture, it can lead to a diagnosis maze or even misdiagnosis.

You may also be interested in reading:

• 2010 set of criteria for diagnosing Fibromyalgia.

• What are the main fibromyalgia symptoms?

• How do doctors tell if it's fibromyalgia or another condition?​

Thanks for reading my blog. I am Lee Good and I was diagnosed with Fibromyalgia in 1990 by an endocrinologist. I have spent many years researching and writing about Fibromyalgia. 

Diagnosing Fibromyalgia

Diagnosis of FMS is performed mostly in the primary care setting. However, tender point examination rarely is performed in this setting, and when it is performed, it often is done incorrectly - See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.aWEKP0OI.dpuf

Diagnosis of FMS is performed mostly in the primary care setting. However, tender point examination rarely is performed in this setting, and when it is performed, it often is done incorrectly - See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.aWEKP0OI.dpuf

Diagnosis of FMS is performed mostly in the primary care setting. However, tender point examination rarely is performed in this setting, and when it is performed, it often is done incorrectly - See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.aWEKP0OI.dpuf

Diagnosis of FMS is performed mostly in the primary care setting. However, tender point examination rarely is performed in this setting, and when it is performed, it often is done incorrectly - See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.aWEKP0OI.dpuf

Diagnosis of FMS is performed mostly in the primary care setting. However, tender point examination rarely is performed in this setting, and when it is performed, it often is done incorrectly - See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.aWEKP0OI.dpuf

Fibromyalgia is a complex, chronic condition that causes widespread pain, fatigue, and cognitive challenges. 

Diagnosis is usually made by a family doctor or rheumatologist, but it’s not always straightforward. 

Historically, the tender point test was used—but studies show it was often applied incorrectly and lacked sensitivity as it was often done incorrectly. *

The tender point test investigated 19 pain locations and 6 self-reported symptoms: difficulty sleeping, fatigue, poor cognition, headaches, depression, and abdominal pain. It would help a GP get insight into your symptoms and their severity.

 What’s Changed?

The updated diagnostic criteria emphasizes a multidimensional approach that better reflects the lived experience of fibromyalgia. Instead of focusing solely on physical exam findings, doctors now use a combination of:

• Widespread Pain Index (WPI): Assesses pain in 19 body regions.

• Symptom Severity Scale (SSS): Rates fatigue, unrefreshing sleep, cognitive symptoms, and other somatic complaints like headaches, depression, and abdominal pain.

• Duration of Symptoms: Symptoms must be present at a similar level for at least three months.

• Exclusion of Other Conditions: Doctors must rule out other causes of pain and fatigue, such as autoimmune diseases or thyroid disorders.

This updated framework helps GPs and specialists gain a clearer picture of symptom severity and distribution—especially when symptoms overlap with other chronic illnesses.

The 2016 revisions to the 2010/2011 criteria for diagnosing Fibromyalgia remain the most widely recognized and validated framework for diagnosing fibromyalgia, especially in clinical and research settings.

Summary of the evolution:

• 1990: Tender point exam introduced—limited and often misapplied

• 2010: Shift to patient-reported symptoms (WPI + SS)

• 2011: Refinements to improve usability

• 2016: Further revisions to enhance diagnostic accuracy and better reflect generalized pain and polysymptomatic distress

This progression reflects a growing recognition of fibromyalgia as a multisystem condition, not just a localized pain disorder. The move toward patient-centered criteria has empowered more accurate diagnoses and validation of lived experience.

What Is the Fibro Criteria Survey?

The Fibro Criteria Survey is a self-report tool based on the WPI and SSS. It’s not a diagnostic test on its own, but it can help your doctor understand your symptoms more thoroughly. It’s especially useful for tracking changes over time or preparing for appointments. Get the pdf here.

A Note on Self-Diagnosis

Fibromyalgia should always be diagnosed by a qualified medical professional. While self-advocacy is essential, patients should not diagnose themselves. If you suspect fibromyalgia, bring your symptoms to a trusted GP or specialist and ask for a thorough evaluation.

*  Fitzcharles MA, Boulos P. Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Rheumatology (Oxford). 2003;42:263-267. 

   Buskila D, Neumann L, Sibirski D, Shvartzman P. Awareness of diagnostic and clinical features of fibromyalgia among family physicians. Fam Pract. 1997;14:238-241.

Fitzcharles MA, Boulos P. Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Rheumatology (Oxford). 2003;42:263-267.
4. Buskila D, Neumann L, Sibirski D, Shvartzman P. Awareness of diagnostic and clinical features of fibromyalgia among family physicians. Fam Pract. 1997;14:238-241.
- See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.T4XiYuC7.dpuf

Fitzcharles MA, Boulos P. Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Rheumatology (Oxford). 2003;42:263-267.
4. Buskila D, Neumann L, Sibirski D, Shvartzman P. Awareness of diagnostic and clinical features of fibromyalgia among family physicians. Fam Pract. 1997;14:238-241.
- See more at: http://www.rheumatologynetwork.com/fibromyalgia/new-and-modified-fibromyalgia-diagnostic-criteria#sthash.T4XiYuC7.dpuf