Repetitive transcranial magnetic stimulation (rTMS) effectively relieves pain intensity in patients with fibromyalgia. The frequency and target site of rTMS have significant roles in therapy effectiveness.

In contrast, fibromyalgia (FM) subjects' experimental pain ratings increase after aerobic exercise, suggestive of abnormal pain modulation.

3.1.2. Fibromyalgia Three Randomized controlled trials and one observational study focused on fibromyalgia (FM). These studies were published between 2007 and 2019 and included 219 patients. All studies reported significant pain and FM symptoms reduction and quality of life improvement. In particular, fabrics coated with bioceramics could decrease FM-associated pain and burden in female patients by 21% in the VAS and FIQ assessment scales [17]. WAON therapy (soothing warmth therapy) was associated with an even greater improvement of FM symptoms assessed by both scales (52.7% in VAS, 34.6% in FIQ) in both male and female patients [16]. Similar results were reported with the use of AE and FIR [16] and mild water-filtered near-infrared whole-body hyperthermia (NI-WBH) [15] in both male and female patients. The latter appeared as a beneficial addition to standard multimodal rehabilitation (MR) sessions [15]. FIR treatment sessions were provided for 2–6 weeks [16,18], and patients were monitored for a time period ranging between 2 weeks and 6 months [15]. The reported relief was maintained during the monitoring period [18] or was significant within the first 6 weeks post-treatment [15].

oxidative stress hypothesis

Although very few studies have shown elevated cytokine levels in FMS, the data available suggest that a high chemokine level may play a causative role in this disease

A review of the FMS literature and related studies suggest that IL-1, IL-6 and IL-8 are deregulated in the syndrome. Therefore, therapies directed against these cytokines and others may be of potential importance in the management of FMS