Fibromyalgia: What Patients Need to Know About Pain and the Nervous System

The New England Journal of Medicine has published guidance on fibromyalgia, explaining that the condition’s widespread pain is linked to how the central nervous system processes signals — not necessarily to tissue damage or inflammation.

The New England Journal of Medicine (@NEJM) has posted about fibromyalgia (a long-term condition causing widespread pain, fatigue, and heightened sensitivity to touch), highlighting a point that many patients find reassuring: pain does not always mean something in the body is visibly damaged or inflamed. According to the journal, problems with how the central nervous system (CNS) processes pain signals can produce very real and significant discomfort without any detectable injury.

That distinction matters. People living with fibromyalgia are often told their test results look normal, which can leave them feeling dismissed or confused about why they hurt. The journal’s guidance frames reassurance — explaining the CNS processing mechanism to patients — as a recognised part of care.

Fibromyalgia affects an estimated 1 in 20 people in the UK, according to the NHS, and is more commonly diagnosed in women. Symptoms can include persistent pain across the body, extreme tiredness, difficulty sleeping, and problems with memory or concentration, sometimes called “fibro fog.”

There is no cure, but the NHS says a combination of exercise, talking therapies, and medication can help manage symptoms. Getting the right diagnosis is often the first hurdle — and understanding that the pain is rooted in nervous system sensitivity, rather than ongoing damage, can itself reduce distress for some patients.

Key information

• If you think you may have fibromyalgia, speak to your GP — diagnosis is usually based on your symptoms and ruling out other conditions
• NHS 111 (call 111 or use the 111 online service) can advise if you’re unsure whether to seek urgent help
• For mental health support related to living with a long-term condition, the Samaritans are available 24 hours a day on 116 123