Abstract: Fibromyalgia is a chronic disorder of widespread pain, fatigue, sleep disturbance, cognitive dysfunction, and affective symptoms. Central sensitization is characterized by heightened responsiveness of central nociceptive pathways, impaired descending inhibition, and neuroinflammatory processes, is widely recognized as a core pathophysiological mechanism in fibromyalgia. Conventional pharmacologic and behavioral interventions provide partial relief, leaving many patients to pursue complementary approaches. Ayurveda, an individualized medical system emphasizing dosha balance, detoxification (Panchakarma), tissue nourishment (Rasayana), and lifestyle modulation, offers a multimodal framework that aligns with several mechanistic features of Central sensitization. This review synthesizes contemporary neuroscience and immunology of Central sensitization with classical and contemporary Ayurvedic theory to create a translational model linking Vata aggravation, Ama accumulation, and Majja (nervous tissue) depletion to neurochemical, neuroimmune, autonomic, and gut–brain axis dysfunction observed in fibromyalgia. Evidence from preclinical studies on key medhya (neuroprotective) herbs (Withaniasomnifera, Bacopamonnieri, Centellaasiatica), clinical pilot studies of Panchakarma protocols (including Snehana, Swedana, Basti, and Shirodhara), and emerging biomarker and neuroimaging data are reviewed. Proposed mechanistic pathways include modulation of NMDA/GABA balance, attenuation of microglial activation and pro-inflammatory cytokines, restoration of HPA and autonomic tone, and gut microbiome normalization. We identify key research gaps that need for randomized controlled trials, standardized intervention protocols, biomarker-driven endpoints, and mechanistic neuroimaging and propose a roadmap for integrative clinical trials that can validate Ayurvedic interventions within modern pain science. Integrative care grounded in rigorous research could expand therapeutic options for fibromyalgia patients with central sensitization.

Keywords: Fibromyalgia, Central Sensitization, Ayurveda, Panchakarma, Rasayana Therapy, Neuroinflammation, VataVyadhi.