TMS is a noninvasive neuromodulation technique that uses magnetic pulses to stimulate specific brain regions involved in pain processing and modulation. In fibromyalgia, research suggests that TMS—typically in repetitive (rTMS) protocols—may help reduce widespread pain, ease fatigue, and improve quality of life by restoring balance in the brain’s pain networks. Several randomized controlled trials and meta-analyses have shown that rTMS can yield modest to moderate reductions in pain compared to sham stimulation, particularly when targeting areas like the motor cortex (M1) or dorsolateral prefrontal cortex (DLPFC). However, TMS for fibromyalgia is still considered off-label (i.e. not FDA-approved for this indication) and research results are heterogeneous, so it is best viewed currently as a promising adjunctive option for patients who have not achieved sufficient relief with standard therapies.