Integrative Korean medicine intervention incorporating angelica gigas for refractory chronic fibromyalgia: A clinical case report

Fibromyalgia is a disorder characterized by abnormalities in central nervous system pain processing. presenting with widespread pain, fatigue, sleep disturbances, and cognitive impairment, and affects an estimated 2-4 % of the global population. This case report describes a woman in her 50 s with a 10-year history of fibromyalgia who had undergone various pharmacological treatments, including opioid analgesics, at multiple institutions without meaningful symptomatic improvement. The patient presented with persistent widespread pain, nocturnal pain-related sleep disturbance, and functional impairment, and had been maintained on long-term buprenorphine patch therapy and multiple oral analgesics. During a 6-week inpatient course of integrative Korean medicine treatment (including herbal medicine, acupuncture, pharmacopuncture, Chuna manual therapy, and physical therapy), both objective and subjective improvements were observed in pain severity (Numeric Rating Scale), quality of life (EuroQol 5-Dimension), functional measures (WOMAC, SPADI, ODI, NDI), and joint range of motion. A blood stasis pattern, likely associated with prolonged analgesic use, was identified as the primary pathological mechanism, and the core therapeutic strategy was centered on a blood-activating prescription incorporating high-dose Angelica gigas (Korean Danggui). The observed improvements suggest that integrative Korean medicine may serve as a viable adjunctive option for refractory fibromyalgia.