Personalized Ultrasonic Brain Stimulation for Fibromyalgia

Inclusion Criteria: * Meets American College of Rheumatology criteria for fibromyalgia: * Generalized pain, defined as pain in at least 4 of 5 regions, is present. * Widespread pain index (WPI) ≥ 7 and symptom severity scale score (SSS) ≥ 5, or WPI of 4-6 and SSS score ≥ 9. * Symptoms have been present at a similar level for at least 3 months. * d.A diagnosis of fibromyalgia is valid irrespective of other diagnoses. A diagnosis of fibromyalgia does not exclude the presence of other clinically important illnesses * Failure of at least two evidence based medications (i.e., pregabalin, duloxetine, milnacipran) for the treatment of fibromyalgia. * Failure of one or more attempts at physical therapy including: * Aerobic exercise like walking, cycling, and swimming, * Water therapy/hydrotherapy with warm water exercises, * Tai Chi involving slow, controlled movements, * Yoga, * Resistance training, * Bodyweight exercises, * Pilates, * Myofascial release therapy applying gentle pressure on trigger points, * Massage therapy, * Trigger point therapy targeting specific pain points, * Joint mobilization, * Postural retraining to correct body alignment, * Balance and coordination exercises, * Feldenkrais method for movement awareness, * Alexander technique to enhance posture and movement efficiency, * Transcutaneous Electrical Nerve Stimulation (TENS) for pain relief, * Heat therapy using hot packs, infrared, or paraffin wax, * Cold therapy …