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It's characterized by chronic widespread pain lasting at least 3 months, accompanied by fatigue, unrefreshing sleep, and cognitive difficulties commonly called "fibro fog." Recent research has shifted understanding of fibromyalgia from a purely psychosomatic condition to a disorder with identifiable biological mechanisms: Central sensitization: Functional MRI studies show that fibromyalgia patients have heightened activation in pain-processing brain regions (anterior cingulate cortex, insula, prefrontal cortex) in response to stimuli that don't activate these regions in healthy controls Insulin resistance: A 2019 study in PLOS One found that fibromyalgia patients had significantly higher HOMA-IR scores than matched controls, and that HbA1c levels correlated with pain severity
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