What the condition actually is.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases describes fibromyalgia as a chronic, long-lasting disorder causing pain and tenderness throughout the body, along with fatigue and trouble sleeping. MedlinePlus, from the National Library of Medicine, describes the same core: pain and stiffness all over the body, tiredness, and difficulty sleeping.
Around that core sit symptoms people rarely think to mention. NIAMS lists muscle stiffness and tenderness, numbness or tingling, heightened sensitivity to light, noise, odors, and temperature, digestive trouble, and problems with concentration and memory. The American College of Rheumatology adds headaches, depression, anxiety, and urinary problems to the picture.
It is not rare. The American College of Rheumatology puts it at 2 to 4 percent of people, most often women. NIAMS notes it occurs more often in women than men, more often in middle age and older, and more often in people with a family history, an existing rheumatic disease, a mood disorder, or another chronic pain condition.
Why the tests come back clean.
Here is the sentence that reframes most of this. The American College of Rheumatology states that fibromyalgia is not an inflammatory or autoimmune disease and has no single diagnostic test. Tests may be ordered to rule out other explanations — a thyroid problem or an inflammatory disease — rather than to establish fibromyalgia by themselves.
So a clean panel is the expected result. It is not evidence that nothing is happening, and it is not a quiet way of saying the pain was invented. NIAMS puts the mechanism plainly: people with fibromyalgia have an increased sensitivity to pain, meaning they feel pain when others do not, and research indicates altered signaling in the neural pathways that transmit and receive pain. The American College of Rheumatology likewise says research suggests the nervous system is involved.
Be careful about how far that gets stretched. NIAMS and MedlinePlus both state that the exact cause of fibromyalgia is unknown. Altered pain signaling is a real research finding, not a finished explanation, and no one — including anyone who has not examined you — can tell you which mechanism is producing your particular pain.
What tends to travel alongside it.
MedlinePlus notes that people with fibromyalgia are more likely to have anxiety, depression, headaches and migraines, irritable bowel syndrome, and temporomandibular joint syndrome. That clustering is worth knowing about before you sit down with a clinician, because these often get discussed as separate complaints in separate appointments when they may be worth looking at together.
There is a flip side, though, and it matters more than the clustering does. Because fibromyalgia is identified partly by ruling other things out, a new symptom should not be automatically filed under a diagnosis you already have. Chest pain, a sudden change in an old pattern, a fever, weakness, numbness that follows a nerve's path — those get evaluated on their own terms rather than absorbed into the existing label.
- Note when the pain is worst, and what the night before looked like.
- Record which symptoms move together and which move on their own.
- Write down anything genuinely new or different, separately from the usual.
- Bring a full list of medicines and supplements, with doses.
How qualified clinicians work through it.
There are no specific laboratory or imaging tests for fibromyalgia. NIAMS describes what happens instead: a medical history covering the location, severity, and duration of the pain and whether fatigue or cognitive problems are present; a physical examination of the joints to rule out conditions such as rheumatoid arthritis or lupus; and laboratory or imaging tests ordered to help rule out other diseases and conditions.
MedlinePlus says directly that fibromyalgia can be hard to diagnose. That difficulty is a property of the condition rather than a failure of the person describing it, and it is why the history you bring carries so much weight. Specific, written detail about what hurts, for how long, and what else is happening does more work in that appointment than any single test result will.
What the evidence supports, and where it thins out.
NIAMS states there is no cure for fibromyalgia, while noting symptoms can be managed, and describes treatment as typically combining exercise or other movement therapies, psychological and behavioral therapy, and medications. On the movement piece the sources converge unusually hard: the American College of Rheumatology calls exercise the most effective treatment, naming yoga, tai chi, and other low-impact aerobic activity, and the National Center for Complementary and Integrative Health says research has repeatedly shown regular exercise to be one of the most effective treatments for the condition. NIAMS advises starting at low levels and building.
On medication, three drugs are FDA-approved for fibromyalgia according to the American College of Rheumatology: duloxetine, milnacipran, and pregabalin. NIAMS notes antidepressants can help fibromyalgia symptoms even in people without depression, and that anti-seizure medicines can lessen pain and improve sleep, while anti-inflammatory drugs are typically not effective for it — which follows from the condition not being inflammatory in the first place. The American College of Rheumatology states that opioids and sleep medicines such as zolpidem are not recommended. Every one of those decisions belongs to the clinician who prescribes for you.
The complementary side deserves an honest accounting rather than a hopeful one. NCCIH reports that acupuncture has not been shown to be more effective than simulated acupuncture for fibromyalgia symptoms; that mindfulness meditation training has produced short-term improvements in pain and quality of life across several studies, though the number of studies is small and the evidence quality relatively low; that massage appears to offer short-term relief of some symptoms but the evidence is too limited to be conclusive; and that tai chi, qigong, and yoga have had promising individual results without enough high-quality evidence for definite conclusions. Alongside all of it, NIAMS points to unglamorous basics — cognitive behavioral therapy, a consistent bedtime routine, a dark and quiet and cool bedroom, and pacing activity so a good day does not purchase a bad week.
Where this practice fits, and what to ask.
Gates Brain Health publicly describes itself as providing functional neurology care in Reno, Nevada, and its published focus includes fibromyalgia. Dr. Randall Gates, D.C., DACNB is a board-certified chiropractic neurologist; he is not a medical doctor. Care here sits alongside your existing clinicians rather than in place of them — it does not replace a primary care provider or a rheumatologist, and prescribing decisions stay with whoever prescribes.
Whether this practice is a fit for your situation is not something a web page can decide, and this one is not going to pretend otherwise. That gets worked out on a call and, if it goes further, an evaluation. Call (775) 507-2000, Monday through Friday, 8:00 AM to 5:00 PM, and ask about weekend availability if the weekday hours do not work. Please keep medical details to the phone or the office rather than the website.
- What would an evaluation involve, and what would it be looking for?
- How would this work alongside the rheumatologist or primary care provider I already see?
- What happens if you decide my situation is not a fit here?
- What should I expect you to be able to tell me, and what will you not be able to tell me?
About this page.
This was published on May 18, 2018 as a video episode of the practice's radio show, under the title above. That date is preserved and has not been altered. The episode itself is not embedded, transcribed, or linked here, because permission to reuse the recording has not been confirmed.
No author byline and no clinician reviewer are attributed, because the archived record does not establish either. The medical content on this page comes from the agencies and the professional society named in the sources below, added on July 15, 2026. That is a source-check date. It is not a republication date, not a medical-review date, and not a review of your health.