Fibromyalgia: A Real Central-Pain Disorder, Managed by Exercise Not Cured by a Supplement

Summary

Fibromyalgia is a genuine central-sensitisation (nociplastic) pain disorder with objective CNS signatures — not faking, not just depression — and the best-evidenced management is a bundle led by graded, self-paced aerobic and strength exercise (the single strongest lever and the only therapy the European guideline rates "strong for"), supported by sleep work, CBT and pain-neuroscience education, with modest-benefit drugs (duloxetine, pregabalin, milnacipran, low-dose amitriptyline) that help roughly one in six to ten people; it is over-claimed in both directions at once — dismissed as "not rea