Fibromyalgia (Fibromyositis): An elusive inflammatory myopathy - A case report

Fibromyalgia is a chronic pain syndrome characterized by widespread musculoskeletal pain, stiffness, fatigue, sleep disturbance, and psychological symptoms, with unclear etiology and complex pathophysiology involving central sensitization and possible inflammatory mechanisms. This case report describes a 52-year-old male presenting with chronic right-shoulder pain and stiffness of two years’ duration, associated with constipation with ineffectual urging, disturbed sleep with early morning waking, irritability, and hypersensitivity to stress. Clinical examination and differential diagnosis ruled out structural shoulder pathologies, leading to a diagnosis of fibromyalgia (Fibromyositis) based on symptom totality. An individualized homeopathic approach was adopted following repertorial analysis. The remedy Nux vomica was prescribed in ascending potencies (30C, 200C, and 1M) along with placebo and lifestyle advice including meditation and counseling. Over a follow-up period of approximately four and a half months, the patient demonstrated progressive improvement: reduction and eventual resolution of shoulder pain and stiffness, normalization of bowel habits, significant improvement in sleep quality, and marked reduction in irritability with improved stress tolerance. This case suggests a positive clinical outcome following individualized homeopathic management in fibromyalgia. However, as a single-case observation, causal inference cannot be established. Controlled clinical studies are required to further evaluate the role of Nux vomica in the management of fibromyalgia.