HEALIO MINUTE, April 10, 2025
The hidden culprit behind fibromyalgia’s agony — could diet be the key?
For millions suffering from fibromyalgia, the relentless cycle of chronic pain, fatigue and inflammation can feel like an unbreakable loop.
While pharmaceutical treatments offer partial relief, a groundbreaking new study sheds light on a critical and often overlooked factor that may be fueling the disease: diet.
Recently published in Pain Medicine, the study by Nursena Ersoy Söke, PhD, and colleagues provides compelling evidence that a proinflammatory diet worsens pain, disease severity and inflammation in patients with fibromyalgia.
Using the Dietary Inflammatory Index, the researchers evaluated how daily food choices influence pain levels and biochemical markers associated with inflammation. Their findings suggest that patients consuming a diet high in inflammatory foods such as refined sugars, processed foods and unhealthy fats experience higher pain scores, increased disease burden and elevated uric acid/creatinine ratios, a marker of systemic inflammation.
Why this matters
Fibromyalgia is a perplexing condition that affects 2% to 6% of the U.S. population, with no definitive cure.
Traditionally, treatment has focused on painkillers, physical therapy and other symptom management strategies. However, this study reinforces the growing evidence that nutrition plays a crucial role in chronic pain conditions.
The implications are profound: by shifting to anti-inflammatory diets rich in whole foods, fiber, vitamins and healthy fats, patients may reduce pain severity and improve their quality of life.
The science of food and pain
Inflammation is a known driver of fibromyalgia symptoms. The study highlights that proinflammatory cytokines such as interleukin-6 and tumor necrosis factor-alpha are elevated in patients with fibromyalgia, worsening pain perception and fatigue. Furthermore, excess body fat — especially visceral fat — can amplify inflammation by releasing harmful cytokines into the bloodstream, creating a vicious cycle of pain and metabolic dysfunction.
One of the most significant biochemical findings in the study was the increased uric acid/creatinine ratio in patients with fibromyalgia consuming a proinflammatory diet. Uric acid is a byproduct of purine metabolism and, in excessive amounts, can act as a prooxidant, triggering oxidative stress and inflammation. Elevated uric acid levels are associated with inflammatory diseases and chronic pain conditions, and an increased uric acid/creatinine ratio may indicate an impaired metabolic state contributing to fibromyalgia symptoms. This suggests that dietary modifications aimed at reducing inflammation may not only alleviate pain but also help regulate metabolic imbalances in these patients.
The authors also point to nutritional deficiencies as potential aggravators of fibromyalgia, noting that low levels of fiber, magnesium and vitamin C were associated with higher inflammation scores. This aligns with previous research showing that anti-inflammatory diets, such as the Mediterranean diet or plant-based regimens, can significantly reduce chronic pain and inflammation.
A paradigm shift in pain management
I see this study as a critical step forward in broadening the treatment paradigm for patients with fibromyalgia.
For too long, fibromyalgia has been managed primarily through pharmacological means, yet we continue to see patients struggle with persistent symptoms and medication side effects. This study underscores the crucial role of diet in pain modulation and systemic inflammation. In my practice, I see firsthand how metabolic health influences chronic pain, and these findings reinforce the importance of an integrative approach. Patients with fibromyalgia should not only receive medications but also structured nutritional guidance to reduce inflammation and improve their quality of life.
These findings align with emerging pain research, which focuses on modulating inflammatory responses and addressing metabolic factors that influence chronic pain.
As pain specialists, we must embrace a multidisciplinary approach, but lifestyle modifications including diet must be part of the conversation. This study provides valuable data that should encourage both clinicians and patients to rethink how we approach fibromyalgia treatment.
A call for dietary interventions
If diet is indeed a powerful modulator of pain, why aren’t more physicians prescribing nutritional interventions as a first-line treatment for fibromyalgia? Medical guidelines still emphasize pharmaceutical management, despite growing evidence that lifestyle changes can make a meaningful difference.
The European Alliance of Associations for Rheumatology already recommends a multidisciplinary approach to fibromyalgia, which includes nonpharmacological strategies like exercise and cognitive behavioral therapy. It may be time to elevate dietary counseling to the same level of importance in clinical care.
What’s next?
While the findings are promising, more large-scale, long-term studies are needed to confirm the impact of diet on fibromyalgia outcomes. The study’s cross-sectional design means it can show associations but not direct causation. Still, for patients seeking relief beyond medications, this research offers hope — and a tangible, actionable path forward.
For health care providers, these findings reinforce the importance of integrating dietary assessments into chronic pain management. For patients with fibromyalgia, it signals an opportunity to reclaim some control — one meal at a time.
If food can be medicine, perhaps it’s time we start
