Fibromyalgia

Fibromyalgia is a condition that causes widespread pain throughout the body, often accompanied by fatigue, poor sleep, and headaches. The pain is typically felt in several areas at the same time—for example, the neck, shoulders, back, hips, and arms—and it may move around or vary in intensity from day to day. Many people also find that they are unusually tender, almost as if their skin and muscles have become more sensitive to pressure and touch than they used to be.

As with neuropathic pain, fibromyalgia is thought to be largely caused by changes in the way the brain and nervous system process pain signals. In simple terms, the brain becomes overly sensitive and interprets normal signals from the body as painful, even though there is no injury or disease in the tissues that hurt. This is why routine tests such as blood tests, X-rays, or scans are usually completely normal, even though the pain is very real and can have a significant impact on daily life.

In addition to widespread pain, many people with fibromyalgia also experience:

• Persistent fatigue, even after a full night’s sleep
• Light or unrefreshing sleep
• Difficulty concentrating and memory problems, often referred to as “fibro fog”
• Headaches or tension-type headaches
• A feeling of stiffness throughout the body, especially in the morning
• Increased sensitivity to sound, light, or temperature

Fibromyalgia is not a condition that can be seen on a scan, but it is a well-recognized and well-documented medical diagnosis. The symptoms are genuine and are not “all in your head.”

For fibromyalgia, as with neuropathic pain, we target a specific area of the brain called the primary motor cortex (M1). Because fibromyalgia is largely thought to result from the brain becoming overly sensitive to pain signals, the goal of rTMS is to help the brain reduce this heightened sensitivity and restore a more normal pain threshold.

Just like building muscle, changing the brain’s networks takes repetition. For this reason, treatment is delivered over multiple sessions, allowing the effects to build up gradually over time. The goal is to reduce the impact of pain on your daily life while improving your energy levels and sleep quality.

Treatment takes place in the clinic while you are awake and comfortably seated in a chair. During the session, you will feel a gentle tapping sensation and hear clicking sounds from the device. The treatment is not painful, and you can return home immediately afterwards. The stimulation itself lasts no more than 20 minutes, and we set aside at least 45 minutes for each appointment to allow time for preparation and a short conversation.

A full course of treatment usually consists of 10 sessions over 2 to 6 weeks. In the first week, treatment is typically given five times, followed by one or two sessions per week during the following weeks.

You do not need to stop taking your current medications to receive rTMS. It is often used alongside your existing treatment, such as medication, physiotherapy, or exercise, as part of a comprehensive treatment plan.

The benefits of rTMS for fibromyalgia vary from person to person. Some people experience a noticeable reduction in pain and improved sleep, while others see more moderate improvements. Unfortunately, a small number of people experience little or no benefit. When the treatment is effective, the improvement is usually gradual, developing over several weeks rather than from one day to the next.

For many people, the benefits go beyond simply reducing pain. Treatment may also lead to increased energy, clearer thinking, and a greater ability to take part in everyday activities such as going for walks, managing household tasks, or spending time with family and friends. For some, the effects are long-lasting, while others may benefit from occasional maintenance sessions to help sustain the improvements over time.

The side effects of rTMS are generally mild and usually resolve quickly. The most common are a mild, short-lived headache or slight discomfort during the stimulation itself, particularly during the first few treatment sessions.

Fibromyalgia is often treated with a combination of physical activity, strategies to improve sleep, pain management techniques, and, when appropriate, medication. While these approaches help many people, some continue to experience significant pain or troublesome side effects from medication.

rTMS offers a different approach by targeting the areas of the brain involved in processing and regulating pain. The treatment does not require surgery, anaesthesia, or additional medication, and you can continue your normal daily activities throughout the course of treatment.

rTMS can be used alongside the treatment you are already receiving. If it helps reduce your pain, it may also make it easier to stay active, sleep better, and have more energy for the activities that matter most in your everyday life.