We offer individualized fibromyalgia treatment for widespread pain, fatigue, and nervous system sensitivity. Personalized care is available at our pain clinics in Long Beach, Riverside, Alhambra, and City of Industry.
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Treatment Time
Fibromyalgia care sessions are typically completed within a 2-to-3-hour visit depending on the treatment plan.
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Recovery Time
Minimal downtime. Most patients return to normal activities within 1-3 days.
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Locations Available
Available at all ISS clinics - Long Beach, Alhambra, Riverside, and City of Industry.
Fibromyalgia is not caused by structural damage to muscles or joints, and it typically does not show up on imaging or routine laboratory testing. Instead, it is understood as a disorder of how the nervous system processes pain, where normal sensory input is amplified and interpreted as pain due to a process known as central sensitization.
In this state, the nervous system becomes overly reactive, lowering the threshold for pain perception and disrupting the normal “volume control” that typically dampens unnecessary pain signals. As a result, patients may experience widespread, shifting pain patterns, profound fatigue, sleep disruption, and increased sensitivity to physical and environmental stimuli, often without a clear structural source on diagnostic studies. At our pain clinic, we evaluate both the musculoskeletal and neurological contributors to ensure no overlapping pain generators are being missed.
At Integrative Sports & Spine, a dedicated interventional pain clinic, we take a multimodal treatment approach that may include trigger point injections, targeted nerve blocks, and other interventional procedures to reduce peripheral pain input contributing to central sensitization. We combine this with structured rehabilitation, sleep and activity optimization, and supportive medical management to help calm the nervous system, improve function, and restore quality of life over time.
While fibromyalgia is centrally mediated, peripheral pain inputs from trigger points, myofascial restrictions, facet joints, and inflamed tendons continuously feed the sensitized central nervous system and prevent it from downregulating. Trigger point injections and other targeted interventional treatments reduce these peripheral inputs, removing the continuous nociceptive signal that sustains central sensitization and creating the physiological window in which central nervous system recalibration becomes possible.
Fibromyalgia imposes a cycle in which pain drives inactivity, inactivity causes deconditioning, deconditioning lowers pain tolerance and worsens fatigue, and worsened fatigue drives further inactivity. No single intervention breaks this cycle, but a strategically sequenced combination of pain reduction through injection therapy, graded physical activity restoration, and sleep improvement can interrupt it at multiple points simultaneously. This is the clinical rationale for multimodal treatment.
The standard fibromyalgia treatment conversation in primary care begins and often ends with medication such as duloxetine, pregabalin, or milnacipran that produces modest benefit for some patients and significant side effects for others. Our interventional approach expands the treatment toolkit significantly, offering trigger point therapy, nerve blocks, and regenerative options that provide pain relief through entirely different mechanisms and that can be combined with or used independently of pharmacological treatment.
Non-restorative sleep is not simply a symptom of fibromyalgia, it is an active driver of it. Research consistently shows that disrupting slow-wave sleep in healthy volunteers produces fibromyalgia-like widespread pain within days. Conversely, improving sleep architecture in fibromyalgia patients produces measurable reductions in pain intensity and fatigue independent of any other intervention. Our treatment plans explicitly address sleep quality as a primary therapeutic target rather than an afterthought.
Widespread Myofascial Pain with Trigger Points
Sleep disruption is a core feature of fibromyalgia and can significantly amplify pain sensitivity, fatigue, and cognitive symptoms. Poor sleep quality increases central nervous system sensitization, creating a cycle where pain worsens sleep and poor sleep worsens pain. Treatment focuses on reducing pain drivers and supporting more restorative sleep patterns through a combination of interventional and systemic therapies.
Fibromyalgia with Widespread Myofascial Pain
Trigger points are hyperirritable muscle nodules that contribute to localized and referred pain, and they are common in fibromyalgia. Trigger point injections help deactivate these areas, reduce muscle tension, and decrease ongoing pain signaling that contributes to central sensitization.
Peripheral Neuropathy with Cervical Spine Involvement
Neck-related muscle tension, facet irritation, and nerve sensitivity often contribute to headaches and upper body pain in fibromyalgia. Treating cervical pain sources can reduce one of the major peripheral drivers of widespread symptoms.
Occipital Neuralgia with Fibromyalgia and Lumbar & Pelvic Pain Predominance
Some patients experience stronger symptoms in the lower back, hips, and pelvic region due to regional myofascial and joint dysfunction. Targeted injections to these areas can reduce dominant pain input and improve overall function.
Fibromyalgia Following Trauma or Surgery
Fibromyalgia can develop after injury, surgery, or significant physical stress that triggers persistent nervous system sensitization. Treating residual localized pain generators can reduce the overall symptom burden.
Fibromyalgia with Comorbid Inflammatory Arthritis
When fibromyalgia coexists with autoimmune arthritis, both inflammatory and central pain processes contribute to symptoms. Treatment must address both components to achieve meaningful relief.
Fibromyalgia with Chronic Fatigue and Cognitive Symptoms
Fatigue and “brain fog” often reflect disrupted sleep and autonomic dysfunction alongside chronic pain. Treatment focuses on pacing strategies, sleep improvement, and reducing overall pain load.
Fibromyalgia Refractory to Standard Treatments
Some patients do not respond to medications or traditional therapies alone due to untreated peripheral pain generators. Interventional treatments like trigger point and targeted injections may improve outcomes when prior approaches have failed.
Preparation Guidelines• Bring a written summary of your pain history including when symptoms began, what you believe may have triggered them, how they have evolved over time, and what treatments you have already tried and with what results. The complexity of fibromyalgia means this history is invaluable and saves significant consultation time.
• Bring a complete list of all current medications, supplements, and herbal products, including any previously tried fibromyalgia medications and why they were discontinued.
• Bring any relevant prior imaging, laboratory results, rheumatology or neurology consultation notes, and sleep study results if available.
• If you are currently taking blood-thinning medications and a trigger point or other injection procedure is planned, your physician will advise on appropriate pre-procedure medication management.
• Wear comfortable, loose-fitting clothing that allows access to the areas of your body most affected by pain particularly the neck, shoulders, upper back, and lower back where trigger point injections are most commonly performed.
• Note your current sleep quality, average nightly hours, whether you wake feeling unrefreshed, and any history of diagnosed sleep disorders this information directly shapes your treatment plan.
• Arrive prepared to describe not just your pain but its impact on your function, your work capacity, your activity tolerance, your cognitive performance, and your quality of life. This functional picture is central to how we measure treatment success.
Initial ConsultationYour evaluation begins with the most comprehensive assessment most fibromyalgia patients will have experienced. We take an exhaustive symptom history that maps your pain distribution, identifies your primary functional limitations, explores your sleep quality and fatigue pattern, assesses your cognitive symptoms, and documents your complete prior treatment history. We perform a structured physical examination that includes systematic palpation of recognized fibromyalgia tender point regions, assessment of myofascial trigger points across major muscle groups, evaluation of cervical and lumbar spine mobility and segmental dysfunction, and neurological screening. We review all prior imaging and laboratory work not to find something that was missed but to use normal findings appropriately as evidence that the pain mechanism is central rather than peripheral. We discuss the neuroscience of central sensitization in plain language, because patients who understand what is happening in their nervous system are measurably more engaged and successful with their treatment. We then build a care plan that is realistic about the timeline, specific about the interventions, and designed around your particular symptom pattern and functional goals.
Comfort and Preparation• You are positioned comfortably based on the treatment area, either seated or lying face down depending on the muscle groups being treated.
• The skin over each injection site is thoroughly cleaned to maintain a sterile procedure environment.
• The procedure is explained before treatment begins to ensure you understand each step.
Targeted Treatment• Your physician identifies active trigger points through palpation, confirming taut bands, localized tenderness, and referred pain patterns.
• A small needle is inserted directly into each trigger point, and a local anesthetic is administered to deactivate the irritated muscle area.
• Multiple trigger points are typically treated in one session, and imaging guidance may be used when combined with spinal or nerve block procedures.
Immediate Recovery• Mild muscle soreness at injection sites following trigger point procedures is expected and typically resolves within 24 to 48 hours. This is a normal tissue response to needling, not a sign of injury.
• Apply a warm compress to treated muscle areas after the first 24 hours to relieve post-injection muscle soreness. Unlike joint injections where ice is preferred, warmth is generally more appropriate for post-trigger-point muscle discomfort.
• Gentle movement and light stretching of treated muscles is encouraged in the hours following trigger point injection.
• Immobility allows muscles to tighten back around the treated area and reduces the benefit of the procedure. Avoid strenuous physical activity and heavy muscle loading on the day of your procedure.
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First 72 Hours• A temporary flare in widespread fibromyalgia symptoms such as increased pain, fatigue, or heightened sensitivity in the 24 to 72 hours following trigger point treatment is recognized and does not indicate that the procedure was harmful. It reflects the nervous system's response to afferent input from the procedure itself and typically resolves before the therapeutic benefit becomes apparent.
• Contact our clinic if you experience fever, severe localized pain, or signs of infection at any injection site.
• Continue all prescribed medications as directed unless your physician has specifically advised otherwise.
Long-Term Recovery• Engage fully with the graded activity and physical rehabilitation program prescribed by your physician. For fibromyalgia, exercise is not optional but it is one of the most evidence-supported treatments available. The key is starting below your current tolerance and advancing incrementally to avoid post-exertional flares. Aerobic exercise, aquatic therapy, and tai chi have the strongest evidence base for this condition.
• Prioritize sleep hygiene and the specific sleep restoration strategies your physician recommends. No other single behavioral intervention produces broader improvements across fibromyalgia symptoms than improving slow-wave sleep quality.
• Attend all scheduled follow-up appointments. Fibromyalgia management is iterative, and your physician needs to assess which components of your care plan are producing the greatest benefit, identify any new peripheral pain generators that have become dominant, and adjust the intervention sequence accordingly.
• Understand that improvement in fibromyalgia is not linear. Flares will occur. The clinical measure of progress is not the absence of bad days but the overall trajectory, longer intervals between flares, faster recovery from them, and progressively expanding functional capacity over months.
• Communicate openly with your care team about what is and is not working. Fibromyalgia treatment requires ongoing calibration, and your experiential feedback is the most important data your physician has.
Physicians Who Understand the Neuroscience of Fibromyalgia
The single greatest barrier to effective fibromyalgia care is clinical disbelief from providers who treat it as a diagnosis of exclusion, a somatization disorder, or a complaint that falls outside the scope of interventional medicine. Our physicians understand central sensitization as the physiological reality it is and approach fibromyalgia with the same clinical rigor and diagnostic precision they apply to any other condition with a defined mechanism.
Interventional Tools That Reduce the Peripheral Inputs Driving Sensitization
Most fibromyalgia care operates purely at the central level using medications that modulate neurotransmitters without addressing the peripheral pain generators that sustain the sensitized state. Our trigger point injection program and regional interventional treatments address the peripheral component directly, creating a clinical effect that centrally acting medications alone cannot replicate and that frequently unlocks improvement in patients who have plateaued on standard treatment.
Individualized Treatment Plans That Reflect the Heterogeneity of This Condition
Fibromyalgia presents differently in every patient, with different pain distribution patterns, different dominant symptoms, different triggering histories, different coexisting conditions. A protocol-driven approach produces protocol-level results. Our evaluation identifies which specific features of your fibromyalgia are most amenable to interventional treatment and sequences your care accordingly.
A Team That Measures Success in Functional Terms
Pain scores matter but what matters more to fibromyalgia patients is whether they can return to work, care for their families, exercise without crashing, and engage with their lives. We set functional goals at the outset of treatment and track them throughout, because restoring function is the clinical objective that most accurately reflects what fibromyalgia treatment should achieve.
Fibromyalgia is diagnosed clinically, meaning it is based on your symptom pattern, medical history, and physical examination rather than a single lab test or imaging study. Providers typically look for widespread musculoskeletal pain, fatigue, sleep disturbance, and cognitive symptoms, while also ruling out other conditions such as autoimmune disease, thyroid disorders, or structural spine problems that could explain the symptoms.
Central sensitization is a condition in which the nervous system becomes overly responsive to pain signals, amplifying normal sensations into persistent or widespread pain. In fibromyalgia, this means the brain and spinal cord process pain abnormally, leading to heightened sensitivity even without clear tissue damage. This helps explain why pain can feel widespread and disproportionate to physical findings.
Trigger point injections can be helpful for certain patients with fibromyalgia who also have localized muscle tightness or myofascial pain components. While they do not treat the underlying central sensitization, they can reduce focal pain areas and improve mobility when used as part of a broader treatment plan that includes physical therapy and nervous system modulation strategies.
Fibromyalgia is considered a chronic pain condition without a definitive cure, but symptoms can often be significantly reduced and well controlled. Many patients experience meaningful improvement in pain, sleep, and function with a comprehensive treatment approach that may include medication, physical therapy, stress management, and interventional pain techniques when appropriate.
Fibromyalgia treatment focuses on modulating the nervous system and reducing pain sensitivity rather than repairing structural damage, since no clear tissue injury is present. In contrast, muscle pain or arthritis treatments often target inflammation, joint degeneration, or mechanical injury. Because fibromyalgia involves central sensitization, treatment is typically multidisciplinary and emphasizes both physical and neurological components.
Appropriate, graded exercise is generally beneficial for fibromyalgia and can improve pain tolerance, energy levels, and function over time. However, overexertion or sudden increases in activity can temporarily worsen symptoms, so exercise programs are usually started slowly and adjusted based on individual tolerance. Consistency and gradual progression are more important than intensity.
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Treated for fibromyalgia with widespread trigger point pain
"I spent four years being told my pain was stress or depression. This team was the first to sit down, actually listen, and explain what central sensitization meant for my body. The trigger point injections made a bigger difference than anything I had tried before and finally having a real diagnosis gave me my confidence back."
Treated for fibromyalgia following a motor vehicle accident
"My fibromyalgia started after a car accident and nobody connected the two for years. Once this team identified the original injury sites that were still driving my pain and treated them directly, my overall symptom level dropped dramatically. I am not pain-free but I am functional in a way I had stopped believing was possible."
Treated for fibromyalgia with cervical spine involvement and chronic fatigue
"The neck pain and exhaustion were as bad as the widespread pain for me. Treating the cervical component with injections while also working on my sleep and doing the graded exercise program changed the whole picture. I am back at work full time for the first time in three years."
Fibromyalgia is not imaginary, not inevitable, and not untreatable. It is a condition of central nervous system dysregulation with real physiological mechanisms that respond to targeted, intelligent care. Our fibromyalgia specialists at Integrative Sports & Spine offer an interventional and integrative approach that goes beyond what standard management provides addressing the peripheral pain generators, the neurological amplification, and the functional deficits that define this condition.
Call (833) 476-7377 or click the appointment button below to schedule a consultation at any of our four Southern California pain clinic locations.
The primary interventional tool for fibromyalgia-related myofascial pain precisely targets the hyperirritable muscle nodules that generate referred pain patterns and sustain central sensitization, providing relief that stretching, massage, and oral medication alone cannot achieve.
View MoreA regenerative option for fibromyalgia patients with coexisting tendon, ligament, or joint pathology contributing peripheral pain signals to their sensitized nervous system addressing the structural component of pain with your body's own healing biology.
View MoreComprehensive interventional management for the lumbar spine and pelvic pain that frequently dominates the fibromyalgia symptom picture reduces one of the most significant peripheral pain drivers in this patient population through targeted, image-guided treatment.
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