Managing fibromyalgia (FM) presents significant challenges due to incomplete understanding of its causes and the limited availability of scientifically proven effective therapies, complicating patient care approaches. the widely accepted biopsychosocial model views fibromyalgia (FM) and other chronic pain syndromes as multifactorial in nature. This perspectives raises questions about whether FM should be considered a distinct nosological entity or simply a manifestation of central nervous system (CNS) sensitization [1].

Central sensitization to painful and non-painful stimuli has been considered the essential pathophysiological mechanism for the development of FM. Other theories have been developed considering “distress”, lack of autonomy, neuroinflammation and even a role for immunology in this process [2,3].

Clarifying the role of each of these elements can lead us to new therapeutic targets, but until now these had been proved elusive. Non-pharmacological measures, especially physical exercise, health education and psychological techniques, are those with the strongest scientific evidence. Regarding medications, despite limited evidence, the use of certain antidepressants and anticonvulsants have been approved by regulatory agencies [2].

The objective of this article is to review the treatments in use and to analyze the new knowledge that the literature presents to us (see Fig. 1).