Fibromyalgia
Clinical Dashboard
Fibromyalgia - Single Herb Dashboard
Conventional medicine view
How it defines fibro
Conventional medicine generally defines fibromyalgia as a chronic pain-processing disorder with central sensitization, meaning the nervous system amplifies pain more easily than normal. Common models also include impaired descending pain inhibition and altered serotonin, norepinephrine, dopamine, glutamate, and substance P signaling.
Root cause
There is no single universally proven root cause. The main conventional model is abnormal central pain processing rather than ongoing tissue damage, with contributions from stress-system dysregulation, sleep disturbance, autonomic imbalance, and altered neurotransmitter signaling.
Do treatments cure fibro
No standard medication is considered a cure or permanent fix. The main goal is symptom reduction: lowering pain amplification, improving sleep, reducing fatigue, and helping function.
How long are meds used
If a medication clearly helps, people often stay on it for a few months and many clinicians reassess around 6 months. It is not usually meant to be lifelong by default; if it does not clearly help, it should usually be stopped, and in real-world studies most people stop before 1 year.
Long-term side effects
Duloxetine and similar drugs can cause nausea, dry mouth, constipation, sweating, insomnia, sleepiness, and fatigue. Pregabalin commonly causes dizziness, somnolence, headache, and weight gain in some patients. Tolerability is a major reason people stop treatment.
Gold-standard fibromyalgia medications
| Medication class | What it is commonly used for | What it actually does in the body |
|---|---|---|
| Duloxetine | Often used when fibromyalgia includes severe pain, low mood, or fatigue. | It raises serotonin and norepinephrine signaling in descending pain-control pathways, which can reduce central pain amplification. |
| Milnacipran | Used for widespread pain and fatigue, especially when the goal is stronger norepinephrine support. | It increases serotonin and norepinephrine signaling, especially norepinephrine, which may improve pain inhibition, energy, and function. |
| Pregabalin | Often chosen when sleep disturbance and nerve-like pain are prominent. | It reduces excess release of excitatory neurotransmitters, helping calm hyperexcitable pain circuits and often improving sleep. |
| Amitriptyline | Often used at low dose for pain, poor sleep, and fatigue. | It increases serotonin and norepinephrine signaling and also has sedating effects that may improve sleep quality. |
Neurotransmitters in fibromyalgia
Serotonin
Helps regulate pain inhibition, mood, sleep, appetite, and gut function. Fibromyalgia research often links lower serotonin activity to weaker descending pain control.
Dopamine
Helps regulate motivation, reward, movement, and mental drive. Dopamine dysregulation has been linked to pain processing and fatigue in fibromyalgia.
Norepinephrine
Controls alertness, attention, stress readiness, blood pressure, and pain-modulating pathways. Reduced norepinephrine support may weaken the body’s natural pain dampening system.
Epinephrine
Also called adrenaline. It drives acute stress responses such as higher heart rate, blood pressure, and blood sugar availability, and it may reflect autonomic stress dysregulation in some patients.
Du Huo - Angelica pubescens
Why considered
Often considered when symptoms include aching, heaviness, stiffness, and pain that feels worse with cold or damp weather.
How it may help
Anti-inflammatory and analgesic actions may help reduce musculoskeletal pain signaling.
Best fit
People with prominent body aches, stiffness, and weather-sensitive pain.
Sources
Yan Hu Suo - Corydalis
Why considered
Often discussed for broad analgesic potential in people with widespread pain and pain sensitivity.
How it may help
May modulate dopaminergic and pain pathways, with analgesic effects studied in experimental pain models.
Best fit
People whose main symptoms are diffuse pain and strong pain sensitivity.
Sources
Suan Zao Ren - Ziziphus
Why considered
Often used when poor sleep, irritability, and persistent fatigue are central features.
How it may help
Sedative and anxiolytic effects may support sleep quality, which is a major symptom driver in fibromyalgia.
Best fit
People with insomnia, restless sleep, and next-day exhaustion.
Sources
Huang Qi - Astragalus
Why considered
Used when fatigue, poor resilience, and low recovery capacity are major complaints.
How it may help
Immunomodulatory and anti-inflammatory actions may support energy and recovery rather than directly targeting pain alone.
Best fit
People with marked exhaustion and symptom worsening after exertion.
Sources
Gui Zhi - Cinnamon twig
Why considered
Often considered when body aches, poor circulation, and sensitivity to cold are prominent features.
How it may help
May support circulation and reduce pain or stiffness patterns associated with cold-sensitive myofascial discomfort.
Best fit
People with cold intolerance, stiffness, and achy pain.
Sources