Background: Lifestyle interventions have a direct impact on the gut microbiome, changing its composition and functioning. This opens an innovative way for new therapeutic opportunities for chronic widespread patients. Purpose: The goal of the present study was to evaluate a correlation between lifestyle interventions and the gut microbiome in patients with chronic widespread pain (CWP). Methods: The systematic review was conducted until January 2023. Pain and microbiome were the two keywords selected for this revision. The search was conducted in PubMed, Chochrane, PEDro and ScienceDirect, where 3917 papers were obtained. Clinical trials with lifestyle intervention in CWP patients were selected. Furthermore, these papers had to be related with the gut microbiome, excluding articles related to other types of microbiomes. Results: Only six articles were selected under the eligibility criteria. Lifestyle interventions were exercise, electroacupuncture and ingesting a probiotic. Conclusions: Lifestyle intervention could be a suitable choice to improve the gut microbiome. This fact could be extrapolated into a better quality of life and lesser levels of pain.

Background: Fibromyalgia (FM) is characterized by chronic pain and a complex array of symptoms, with neuroinflammation implicated in its pathophysiology. Methods: This study aimed to explore the association between neuroinflammation, measured through interleukin levels (IL-1, IL-6, IL-8), and clinical outcomes in FM patients. Using a cross-sectional study design, blood levels of these interleukins were correlated with pain severity and disability, assessed via the Fibromyalgia Impact Questionnaire (FIQ) and pain measures. Results: Results indicated that IL-6 and IL-8 may particularly serve as biomarkers for pain severity and disability in FM patients, showing significant associations with worse clinical outcomes. Elevated IL-8 levels, for instance, correlated strongly with increased pain perception and higher disability scores. Conclusions: These findings suggest that specific interleukins are not only elevated in FM but are actively involved in the modulation of pain and disability, underscoring the role of systemic neuroinflammation in the clinical severity of FM. This study contributes to a deeper understanding of the inflammatory mechanisms in FM and underscores the potential of targeting interleukins in therapeutic strategies.

(1) Background: Fibromyalgia syndrome (FM) is a specific condition within the spectrum of musculoskeletal pain disorders, with an estimated global prevalence of 2%. Physical exercise has shown promise in modulating pain and improving physical function without the drawbacks of pharmacotherapy. This study aims to examine the effects of a 6-week telerehabilitation combined exercise program—including mobility, strength, and high-intensity exercises—on pain, psychological variables, and disability in women with fibromyalgia. (2) Methods: In this observational study involving 53 FM patients, the outcomes measured were the pressure pain threshold (PPT), the conditioned pain modulation (CPM) paradigm, levels of pain on the measurement day and the average of the last week (using NRS) the impact of the fibromyalgia (using Fibromyalgia Impact Questionnaire (FIQ), and anxiety (using the Spanish version of the State–Trait Anxiety Inventory—STAI). (3) Results: Statistically significant changes were observed in the intervention group in PPT, CPM, NRS, and FIQ. (4) Conclusions: A six-week telerehabilitation therapeutic exercise intervention consisting of two scheduled exercise sessions per week lasting approximately 45 min each is associated with reduced pain levels, enhanced pain inhibitory pathways, and a decreased impact of fibromyalgia compared to patients who do not adopt a more active lifestyle.

Background/Objectives: Fibromyalgia syndrome (FMS) is a multifactorial pain syndrome not only characterized by widespread pain as the primary symptom but also accompanied by physical, psychological, and cognitive manifestations. Impairments in conditioned pain modulation (CPM) are common in this population; however, there is significant heterogeneity in the CPM response among women with FMS. The Left/Right Judgment Task (LRJT) is a validated method for studying motor imagery in chronic pain patients. Previous scientific evidence has not yet thoroughly investigated the relationship between CPM alterations and motor imagery processes in FMS patients. The aim of this study was to investigate the relationship between CPM and motor imagery. Methods: This is a secondary analysis of a cross-sectional study. Pain intensity (NPRS), disability (FIQ), mechanical hyperalgesia (PPT), descending pain modulation (CPM), and laterality discrimination (LRJT) were assessed in 30 women diagnosed with FMS. Participants were divided into two groups, responder and non-responder, according to their response to the CPM test. Results: Findings showed that the FMS subgroup of non-responders to CPM, performed worse in motor imagery processes (LRJT). Additionally, older age and higher mechanical hyperalgesia were also associated with poorer functioning of the inhibitory system. Conclusions: Women with FMS who are non-responders to CPM exhibit a reduced ability to perform motor imagery processes. Additionally, the non-responder group shown significant differences, such as older age and greater initial mechanical hyperalgesia compared to the responder group.

Background/Objectives: Fibromyalgia (FM) is a syndrome characterized by widespread chronic pain as the primary symptom. Neurophysiological pain mechanisms, such as the function of the descending inhibitory system, are impaired in this condition. The main objective of this study was to compare the results of two paradigms to evaluate CPM in women with FM. The secondary objective was to correlate the results of each CPM paradigm with the clinical status of patients with FM. Methods: One hundred and three FM women were divided into two groups: fifty patients diagnosed with FM were assigned to the conditioned pain modulation (CPM) group using a cold pressor stimulus, and fifty-three patients were assigned to the CPM group using the ischemic pressure stimulus. The main outcome measures were pain intensity, disability, mechanical hyperalgesia, and CPM. Results: The primary analysis revealed significant differences between the results obtained from the different CPM protocols. Poorer outcomes in the cold pressor test correlated with higher pain intensity and a greater disability index. Conclusions: Pain modulation abnormalities in FM patients were evident when using either the cold pressor or ischemic pressure stimuli to establish the CPM paradigm. The cold pressor conditioning stimulus elicited a stronger response than the ischemic pressure stimulus in FM patients.

Introduction: Fibromyalgia (FM) is a multifactorial syndrome involving chronic pain and psychological distress. Psychological traits such as anxiety, depression, and catastrophising are linked to symptom severity. Genetic variability may contribute to these dimensions through mechanisms related to pain modulation and stress response. Objectives: To examine associations between selected genetic polymorphisms and psychological variables in women with FM. Methods: A cross‐sectional study was conducted in 67 women diagnosed with FM. Pain intensity, FM impact and psychological variables—anxiety, depression and catastrophising—were assessed using validated questionnaires. Saliva samples were collected and 10 SNPs were genotyped ( COMT rs4680, DRD3 rs6280, OPRM1 rs1799971, BDNF rs6265, MAOA rs1137070, FKBP5 rs1360780, IL6 rs1800796, TNF rs1800629, IL10 rs1800896, IFITM3 rs12252). Correlations were assessed using Pearson or Spearman coefficients, and associations were examined using ANOVA or Kruskal–Wallis with Tukey or Mann–Whitney post hoc tests. Results: Pain intensity correlated with depression ( r = 0.476, p < 0.001), catastrophising ( r = 0.414, p < 0.001), and anxiety ( r = 0.314, p = 0.009). Catastrophising was related to depression ( r = 0.615, p < 0.001), anxiety ( r = 0.453, p < 0.001), and kinesiophobia ( r = 0.445, p < 0.001). BDNF rs6265 was associated with catastrophising ( p = 0.044), OPRM1 rs1799971 with anxiety ( p = 0.030), and MAOA rs1137070 with depression ( p = 0.020). Conclusions: Psychological variables in FM are interrelated and linked to pain perception. BDNF , OPRM1 and MAOA polymorphisms are associated with indices of psychological vulnerability, underscoring the importance of integrating genetic and psychological perspectives to understand variability in FM. Significance Statement: Genetic variability influences psychological vulnerability in fibromyalgia. Specific variants were associated with key psychological traits: BDNF rs6265 with pain catastrophising, OPRM1 rs1799971 with anxiety, and MAOA rs1137070 with depressive symptoms. These findings reveal an interplay between genetic and psychological factors that may guide more personalised strategies for managing fibromyalgia.