Anti-inflammatory Diets for Chronic Pain Disorders With a Focus on Fibromyalgia: A Narrative Review

Fibromyalgia (FM) is a chronic pain syndrome characterised by widespread musculoskeletal pain accompanied by fatigue, cognitive dysfunction ("fibro fog"), and sleep disturbances. Although traditionally regarded as a non-inflammatory condition, emerging evidence suggests that low-grade inflammation, oxidative stress, autonomic nervous system dysregulation, neuroinflammation, and alterations in the gut microbiota contribute to its pathophysiology. Consequently, anti-inflammatory dietary approaches are increasingly being investigated as adjunctive interventions for the management of FM. This narrative review summarises the effects of dietary patterns, including Mediterranean, plant-based, low-FODMAP (Fermentable Oligo-, Di-, Mono-saccharides, and Polyols), elimination, and ketogenic diets, as well as nutritional supplements such as omega-3 fatty acids and antioxidants, on FM symptoms. Proposed mechanisms include modulation of pro-inflammatory cytokines, attenuation of neuroinflammation, improvement in mitochondrial function, and regulation of the gut microbiota. Although existing findings are promising, the current evidence remains limited by small sample sizes and methodological heterogeneity. Further large-scale, well-designed clinical trials are required to establish the efficacy of dietary interventions in the management of FM.