What is Fibromyalgia? A Clinician’s Guide

Fibromyalgia is one of the most misunderstood medical conditions in modern medicine. Patients often arrive at our office in St. Louis after years of frustration—being told “your labs look fine” or “it’s just stress.” Yet their pain, fatigue, and brain fog are very real and very disruptive. At Sheen Vein (Aesthetics and Functional Medicine), we see fibromyalgia not as a vague diagnosis but as a genuine, complex syndrome that requires careful evaluation and a root-cause approach.

In this article, we’ll explore what fibromyalgia is, how it presents, why it happens, and how a functional medicine perspective can offer hope for long-term relief.

Defining Fibromyalgia

Fibromyalgia is a chronic pain condition characterized by widespread musculoskeletal pain, often accompanied by fatigue, sleep disturbances, cognitive difficulties, and heightened sensitivity to touch or stimuli. Unlike arthritis or degenerative joint disease, fibromyalgia does not cause visible joint damage or inflammation that shows up on X-rays or MRIs. Instead, it affects how the brain and nervous system process pain signals—a phenomenon called central sensitization.

Because there is no single lab test or imaging study to confirm it, fibromyalgia is often diagnosed based on a combination of symptoms and ruling out other conditions. This lack of a definitive test is one reason so many patients feel dismissed or unheard.

Common Symptoms of Fibromyalgia

Fibromyalgia symptoms vary widely but often include:

Widespread pain – typically described as aching, burning, or throbbing pain in multiple areas of the body
Fatigue – even after sleeping, patients often feel unrefreshed and exhausted
Cognitive impairment (“fibro fog”) – difficulty concentrating, memory lapses, and slowed thinking
Sleep disturbances – trouble falling asleep, staying asleep, or achieving deep restorative sleep
Headaches or migraines
Digestive issues – such as irritable bowel syndrome (IBS) or bloating
Mood disorders – higher rates of anxiety and depression, often as a result of chronic suffering

Some patients also report sensitivity to light, sound, or temperature changes. These layers of symptoms create a heavy burden on quality of life.

Who Gets Fibromyalgia?

Fibromyalgia affects an estimated 2–4% of the U.S. population, and women are diagnosed more frequently than men. It often begins in middle adulthood but can occur at any age, including adolescence. Family history increases risk, suggesting a genetic component.

In St. Louis and surrounding communities, we see fibromyalgia patients from all walks of life—teachers, healthcare workers, engineers, parents—people who have had their daily functioning drastically limited by pain and fatigue.

Why Does Fibromyalgia Happen?

The exact cause of fibromyalgia remains unclear, but research highlights several overlapping mechanisms:

1. Central Sensitization

Fibromyalgia is considered a neurological amplification disorder. The nervous system becomes hypersensitive, sending exaggerated pain signals even in response to non-painful stimuli.

2. Neurotransmitter Imbalances

Serotonin, dopamine, and norepinephrine—chemicals that regulate mood, pain, and sleep—are often out of balance in fibromyalgia patients. This explains why antidepressant medications sometimes help symptoms.

3. Stress and Trauma

Many patients report fibromyalgia developing after physical trauma, surgery, infections, or significant emotional stress. Chronic stress can rewire the nervous system, lowering its pain threshold.

4. Sleep Dysfunction

Deep, restorative sleep (slow-wave sleep) is often disrupted in fibromyalgia. Without quality sleep, the body cannot repair muscles or regulate pain properly.

5. Immune and Inflammatory Factors

Emerging research links fibromyalgia to low-grade systemic inflammation and altered immune signaling. Gut health imbalances, chronic infections, and autoimmune tendencies may contribute.

6. Hormonal Dysregulation

Adrenal dysfunction (cortisol imbalance), thyroid disorders, and reproductive hormone fluctuations can all exacerbate fibromyalgia symptoms.

How Fibromyalgia is Diagnosed

The American College of Rheumatology (ACR) criteria focus on:

Widespread pain lasting more than 3 months
Pain on both sides of the body and above and below the waist
The presence of “tender points” in specific body regions (though newer guidelines emphasize symptom clusters instead)

Diagnosis is often made after ruling out other conditions such as lupus, rheumatoid arthritis, multiple sclerosis, or hypothyroidism.

Traditional Approaches to Fibromyalgia

Conventional treatment usually involves a combination of:

Medications – such as pregabalin (Lyrica), duloxetine (Cymbalta), or low-dose antidepressants
Physical therapy and exercise – gentle stretching, yoga, or water aerobics to maintain mobility
Cognitive behavioral therapy (CBT) – to help manage the emotional impact of chronic pain

While these can help some patients, many continue to struggle with residual symptoms. That’s where a functional medicine approach becomes valuable.

A Functional Medicine Approach to Fibromyalgia

At Sheen Vein (Aesthetics and Functional Medicine), we look deeper than symptom management. Our goal is to identify the root imbalances driving each patient’s condition. Common strategies include:

Comprehensive Lab Testing

We often evaluate:

Thyroid function (free T3, free T4, TSH, antibodies)
Adrenal health (cortisol patterns)
Nutrient deficiencies (vitamin D, magnesium, B12, iron)
Gut health (stool testing for dysbiosis, leaky gut, or hidden infections)
Inflammatory markers (CRP, homocysteine)

Nutritional Support

Anti-inflammatory diets rich in whole foods, omega-3 fatty acids, and antioxidants
Elimination of potential triggers such as gluten, dairy, or processed sugar
Supplementation with magnesium, CoQ10, and vitamin D for muscle and mitochondrial support

Lifestyle and Stress Reduction

Restorative practices such as meditation, yoga, and gentle movement
Improved sleep hygiene strategies (dark rooms, consistent schedules, limiting blue light at night)
Breathing techniques or mindfulness to reduce nervous system overactivation

Advanced Therapies

We integrate therapies such as:

Red light therapy (PBM) for muscle pain and mitochondrial repair
Platelet-rich fibrin (PRF) or regenerative medicine techniques for targeted areas of pain
Intravenous nutrient therapy when deficiencies are severe or gut absorption is impaired

This personalized, multi-system approach helps restore balance and gradually decrease symptoms over time.

Living with Fibromyalgia

Fibromyalgia is not “all in your head.” It is a complex disorder with neurological, hormonal, and immune components. While there is no overnight cure, many patients experience dramatic improvements when underlying imbalances are identified and addressed.

We encourage patients to see fibromyalgia not as a fixed identity but as a reversible state of imbalance. With the right support, energy can be restored, pain can be reduced, and life can feel joyful again.

Final Thoughts

Fibromyalgia is real, complex, and treatable with the right approach. If you or someone you love has been struggling with widespread pain, fatigue, or brain fog and feels dismissed by traditional medicine, know that there is another path.

At Sheen Vein (Aesthetics and Functional Medicine) in St. Louis, we bring together advanced diagnostics, functional medicine strategies, and regenerative therapies to uncover the root causes of fibromyalgia and build a personalized healing plan.

You don’t have to accept pain and exhaustion as your normal. Schedule a consultation with us today and take the first step toward reclaiming your life. Visit our contact page to get started.

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