A Review of Movement and Functional Impairments in Fibromyalgia: Implications for Targeted Treatment

Nicole Quodling,1,2 Norman Hoffman,1 Frederick Robert Carrick,1,3– 5 Monèm Jemni1,6,7 1Department of Neurology, Carrick Institute, Cape Canaveral, FL, 32920, USA; 2Coelevate Chiropractic, Walkerville, SA, 5081, Australia; 3Neurology University of Central Florida College of Medicine, Orlando, FL, 23816, USA; 4Burnett School of Biomedical Science, University of Central Florida, Orlando, FL, 32827, USA; 5MGH Institute for Health Professions, Boston, MA, 02129, USA; 6Centre for Mental Health Research in Association with the University of Cambridge, Cambridge, CB2 1TN, UK; 7Faculty of Physical Education, Ningbo University, Ningbo, 315000, People’s Republic of ChinaCorrespondence: Nicole Quodling, Coelevate Chiropractic, 103 Walkerville Terrace, Walkerville, SA, 5081, Australia, Email [email protected]: Fibromyalgia (FM) is a complex and disabling chronic pain condition characterized by widespread musculoskeletal pain, persistent fatigue, cognitive dysfunction, and sleep disturbances. It affects approximately 1– 10% of the general population, with a strong female predominance. Beyond pain, patients often experience hypersensitivity to stimuli such as light, touch, and temperature - a phenomenon attributed to central sensitization. Despite its high prevalence, FM remains poorly understood. The condition is believed to arise from abnormal central sensory processing in interaction with peripheral pain generators and psycho-neuro-endocrine dysfunction. Pharmaceutical therapies provide limited relief, with many patients experiencing minimal improvements in function or quality of life and multiple medications being associated with reduced quality of life indices. Importantly, FM is increasingly associated with deficits in motor control, including impaired balance, altered gait, and reduced postural stability. These functional impairments contribute to sedentary behaviour and disability, yet remain underexplored in the literature compared to pain-related symptoms. This review aims to synthesise the current evidence on motor control deficits, balance dysfunction, gait abnormalities, and psychological and rehabilitative strategies in FM. By understanding these multifactorial impairments, this work seeks to support more holistic, multidisciplinary approaches to FM management.Keywords: central sensitization, movement disorder, gait, balance, posture, exercise