Review – Fibromyalgia and Central Sensitisation are common in Rheumatoid Conditions

Date: 05th August 2026 | By: Dr Lourdes Gaspar

A new systematic review highlights growing evidence that fibromyalgia and central sensitization are common in rheumatoid arthritis (RA), psoriatic arthritis (PsA), and spondyloarthritis (SpA), and may be a key reason why some patients continue to experience significant pain despite good control of inflammation.

https://www.cureus.com/articles/503793-fibromyalgia-and-central-sensitization-in-rheumatoid-arthritis-psoriatic-arthritis-and-spondyloarthritis-a-systematic-review?score_article=true#!/

Historically, persistent pain in inflammatory arthritis was often assumed to reflect ongoing disease activity. However, an increasing body of research shows that many patients also develop fibromyalgia-type pain mechanisms, where the central nervous system becomes more sensitive to pain signals.

This review, including 47 studies, found that fibromyalgia and higher central sensitization symptom burden were consistently associated with:

• Higher disease activity scores
• More widespread pain
• Greater fatigue
• Poorer sleep
• Reduced physical function
• Worse quality of life

Importantly, the review found that symptom severity and objective inflammation do not always move together. A patient may have well-controlled inflammatory disease yet still experience substantial pain and fatigue because of overlapping fibromyalgia or central sensitization.

This matters because fibromyalgia can inflate symptom-based disease activity measures, potentially leading clinicians to believe inflammation is uncontrolled when other pain mechanisms may be driving symptoms.

The message is clear: fibromyalgia is not simply a separate condition that occasionally coexists with inflammatory arthritis. It is increasingly recognised as a clinically significant comorbidity that can influence assessment, treatment decisions, and patient outcomes.

As rheumatology moves toward more personalised care, understanding the interaction between inflammation, nociplastic pain, and central sensitization will be essential to improving outcomes for patients.

#Rheumatology #Fibromyalgia #CentralSensitization #RheumatoidArthritis #PsoriaticArthritis #Spondyloarthritis #ChronicPain #PatientCentredCare #PainScience #HealthcareResearc