Talk:Fibromyalgia

Improving top-importance medicine articles: Join the Vital Signs campaign 2026

The goal of the Wikipedia:WikiProject Medicine/Vital Signs 2026 campaign is to bring all 101 top-importance articles—including this one—up to at least B-class quality. Many of these articles are widely read but overdue for review, so even small improvements can have a big impact.

If you watch or edit this article, your help would be very welcome. You can:

1. Add yourself as a participant
2. Note the state of the article in the Progress table (is the current class still correct?)
3. Update the article based on recent clinical guidelines and review papers
4. Help address gaps, improve clarity for a broad audience, or improve image selection

To reach B class, articles should have: suitable referencing, reasonable coverage, a clear structure, good prose, helpful illustrations, and be understandable to a broad audience. Contributions of any size are appreciated. Femke (talk) 16:00, 20 December 2025 (UTC)

I don’t believe that the article can be substantially improved without a top-level review of the organization. I have fibro fog myself - I get it. But also, I have fibro fog, and the way this is set up, I’m definitely going to forget what information I came in looking for long before I find it. Cghoover8 (talk) 21:56, 13 April 2026 (UTC)

Proposal to update the Lead Paragraph and Short Description

I'd like to propose an update of the short description and a rewrite of the opening overview paragraph to improve readability (per WP:LEAD) and to upgrade the sourcing (per WP:MEDRS).

Currently, the lead relies solely on patient-facing educational websites (the NHS and gesundheitsinformation.de). Because of this, the prose reads a bit like a clunky diagnostic checklist. It also lacks the current medical consensus regarding the pathogenic mechanism of central sensitization, simply describing it as "unknown, with several pathophysiologies proposed."

The short description is vague and oversimplifying, "chronic pain of unknown cause."

I propose smoothing out the prose to be more concise and encyclopedic, upgrading the citations to recent peer-reviewed review articles that specifically highlight central nervous system involvement, and making the short description more clear and precise.

Proposed Short Description: "Chronic multi-symptomatic pain disorder" (replaces "chronic pain of unknown cause").

Proposed New Opening: "Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive difficulties, among other symptoms. [1] While the exact cause remains unknown, central sensitization is a key mechanism of the disorder, involving abnormal pain processing in the central nervous system. [1, 2]

New WP:MEDRS sources to replace the patient education material:

1. Mezhov, V., et al. (2021). "Central sensitivity and fibromyalgia." Internal Medicine Journal. https://doi.org/10.1111/imj.15430 Relevant sections: "Fibromyalgia presents with symptoms of widespread pain, fatigue, sleeping and cognitive disturbances as well as other somatic symptoms. It often overlaps with other conditions termed ‘central sensitivity syndromes’, such as irritable bowel syndrome, chronic fatigue syndrome and temporomandibular disorder. Central sensitisation, mediated by amplified processing in the central nervous system, has been identified as the key pathogenic mechanism in these disorders. The term ‘central sensitivity’ can be used to describe collectively the clinical presentation of these disorders."
2. Siracusa, R., et al. (2021). Fibromyalgia: Pathogenesis, Mechanisms, Diagnosis and Treatment Options Update. International Journal of Molecular Sciences. https://doi.org/10.3390/ijms22083891 Relevant sections: "It is known that fibromyalgia is caused by a central sensitization phenomenon characterized by the dysfunction of neuro-circuits, which involves the perception, transmission and processing of afferent nociceptive stimuli, with the prevalent manifestation of pain at the level of the locomotor system."

Let me know if there are any objections to implementing this cleaner, better-sourced version.

burntsienna (talk) 21:36, 6 May 2026 (UTC)

Please have a look at WP:LLMS. "It also lacks the current medical consensus regarding the pathogenic mechanism of central sensitization" I don't think this is a consensus, and the mechanism(s) underlying central sensitization isn't known. You can see this discussed under the pathophysiology section. In regards to one of the sources you provided, see WP:MDPI.

However I agree that the opening and short description could be improved. I think your proposed short description is an improvement. In terms of getting into the details of the causes/mechanism behind fibromyalgia, I would go into that detail in a paragraph besides the opening paragraph, but something similar to your proposed opening could work. Tristario (talk) 03:34, 7 May 2026 (UTC)

What if I changed the wording to "While the exact cause remains unknown, central sensitization is hypothesized to be a key mechanism of the disorder, involving abnormal pain processing in the central nervous system."

My understanding is that although the pathophysiology is not fully understood, there is at least some consensus that central sensitization and altered pain processing is likely playing some significant role in the disorder, even the details are debated. Do you disagree? It seems unhelpfully vague to simply say "the cause is unknown" with no reference at all to central sensitization. burntsienna (talk) 05:35, 21 May 2026 (UTC)

Maybe you could do something like "While the exact cause remains unknown, the pathogenesis has been hypothesized to involve abnormal pain processing in the central nervous system", and put it in a paragraph besides the first one. Have you looked at this review article, by the way? Tristario (talk) 05:58, 21 May 2026 (UTC)

I have been completing a detailed review of research articles for the last few months, and find that both the evidence base and level of consensus around central sensitization are overstated in public-facing sources. I would summarize that central sensitization is merely a plausible explanation - it can't be demonstrated because it can't be tested. That's not likely to be a permanent problem, but the so-called consensus has gotten way ahead of what the science actually supports. More importantly, a cluster of research projects published starting in 2021 have implicated the dorsal root ganglia (DRG), a group of centrally located structures that are just barely OUTSIDE the central nervous system. Given all that, any discussion of prominent hypotheses belongs in a section below the opening paragraph, where there's room to discuss the ins and outs in more detail. Cghoover8 (talk) 23:53, 16 August 2026 (UTC)

Emerging evidence

What are recommendations for handling cases where statements in the article are inaccurate in light of more recent research? For example, Digestive System under Pathophysiology opens with "Though there is a lack of evidence in this area..." but in fact important findings have been published in this area since the cited review article came out. Cghoover8 (talk) 00:41, 17 August 2026 (UTC)

If there is a good quality WP:MEDRS source that's more recent, like a review article in a good journal, then that could be updated/replaced with that. Although Wikipedia:Neutral point of view also needs to be considered - if different reliable sources give different viewpoints we do also need to present them with appropriate weight Tristario (talk) 00:52, 17 August 2026 (UTC)

What specialty treats fibromyalgia?

As of yesterday, the infobox in this article stated that the specialties treating fibromyalgia are rheumatology and neurology (cited to a 2009 article in the non-peer-reviewed Brain & Life). Fibromyalgia research is published across a range of medical specialties, but no one specialty claims ownership of it at this time. Rather it belongs to an area of medicine that is more of a field or sub-speciality - pain management. The recent, peer-reviewed resources that I examined recommend that fibromyalgia care is best coordinated by a general practitioner and incorporates a range of pain management practices that fall under the term "alternative medicine" - however, these are as mainstream as it gets in fibromyalgia treatment. This approach aligns well with the "Pain Management" article in en.wikipedia.org, and I propose to update the specialty field assigned to fibromyalgia to point to that article. Cghoover8 (talk) 22:00, 17 August 2026 (UTC)

Generally we need sources to state something rather than inferring it ourself, otherwise that can be WP:Original Research, which we aren't supposed to do on article pages. Template:Infobox_medical_condition says the speciality field is for "Main health specialties involved with diagnosis and treatment of the disorder. Example: Psychiatry, clinical psychology". According to this source fibromyalgia is primarily treated by Primary care providers and Rheumatologists, along with some other specialties that may be involved Tristario (talk) 23:15, 17 August 2026 (UTC)

There is no clear process that removes or relocates a disease out of the speciality that it was previously assigned to. However, this meta-analysis reports that when asked that question directly, only 5% of practicing specialists believed fibromyalgia should be treated by rheumatology. The same meta-review shows substantial support for rheumatologists refusing to see fibromyalgia patients. (I realize that personal experience is not an accepted authority in Wikipedia, but it does seem worth noting that that has been my own experience.) In ICD 10, fibromyalgia was classified under "Diseases of the musculoskeletal system and connective tissue" (rheumatology, more or less) and in ICD 11 it was moved to "Chronic widespread pain". Also, the most recent definitional work on fibromyalgia was published by the International Association for the Study of Pain (IASP), not the American College of Rheumatology (ACR) that previously published diagnostic standards. Cghoover8 (talk) 00:51, 28 August 2026 (UTC)

You can include "pain management" as a specialty in the infobox as long as there is a source for it. This source says "[The team may include] your primary health care provider, a specialist called a rheumatologist, a physical therapist, and a pain management clinic." That might be good enough, but rheumatology should also be included since sources indicate that's a specialty fibromyalgia can fall under. Primary care should also probably be included Tristario (talk) 02:23, 28 August 2026 (UTC)

I'm working on a more complete explanation - would that go under Management section? What I'm finding is that pain management is a multi-disciplinary field and the specialties involved vary in different countries. Cghoover8 (talk) 03:26, 28 August 2026 (UTC)

I suppose so. Potentially also under classification Tristario (talk) 02:28, 29 August 2026 (UTC)