Fibromyalgia Specialist in Nassau County, NY
Fibromyalgia is one of the most frustrating diagnoses a patient can receive — not because the condition isn't real, but because it is so often dismissed, misunderstood, and undertreated. Patients with fibromyalgia live with widespread chronic pain, debilitating fatigue, sleep disruption, and cognitive difficulties, and are frequently told there is nothing more to offer beyond medications.
Dr. Edward Rubin takes a different approach. At his Garden City and Lake Success offices, he evaluates fibromyalgia patients thoroughly, looks for treatable contributing factors, and offers targeted interventional options that can significantly reduce pain burden even when standard medications have failed.
What Is Fibromyalgia?
Fibromyalgia is a chronic pain disorder characterized by widespread musculoskeletal pain, heightened pain sensitivity (central sensitization), fatigue, and non-restorative sleep. It is classified as a disorder of central pain processing — meaning the nervous system is amplifying pain signals beyond what the underlying tissue would normally produce.
Fibromyalgia affects approximately 4 million adults in the U.S. It is more common in women and often coexists with other conditions including irritable bowel syndrome, migraine, anxiety, depression, and autoimmune diseases.
Common Symptoms
- Widespread pain — often described as aching, burning, or soreness throughout the body
- Tender points — specific areas that are disproportionately painful with light pressure
- Profound fatigue that does not improve with sleep
- Non-restorative sleep — waking feeling unrefreshed
- Cognitive difficulties — "fibro fog," including trouble concentrating, memory lapses
- Headaches, including tension headaches and migraines
- Sensitivity to light, sound, temperature, and touch
- Irritable bowel symptoms
- Depression and anxiety (highly comorbid)
What Causes Fibromyalgia?
The exact cause is not fully understood, but research points to central sensitization — a state in which the central nervous system becomes hyperactivated and processes pain abnormally. The brain and spinal cord amplify pain signals, and the threshold for pain becomes abnormally low.
Triggers and contributing factors include:
- Physical trauma (especially whiplash-type injuries)
- Severe psychological stress or PTSD
- Viral or bacterial illness
- Autoimmune conditions (lupus, rheumatoid arthritis)
- Sleep disorders
- Genetic predisposition
How Dr. Rubin Treats Fibromyalgia
Dr. Rubin's approach to fibromyalgia is multimodal — combining targeted interventional treatments with coordination of medication management and physical therapy:
Ketamine Infusion Therapy
Ketamine is one of the most promising treatments for fibromyalgia and the central sensitization that drives it. By acting on NMDA receptors in the central nervous system, ketamine can "reset" abnormal pain processing and significantly reduce widespread pain burden. A series of ketamine infusions — typically 4–6 over two weeks — often provides meaningful and lasting improvement in fibromyalgia patients who have not responded to oral medications.
Trigger Point Injections
Patients with fibromyalgia frequently develop active myofascial trigger points — hyperirritable bands of muscle that cause local and referred pain. Trigger point injections break the cycle of muscle spasm and reduce the peripheral pain input that perpetuates central sensitization.
Occipital Nerve Blocks
For fibromyalgia patients with significant headache burden (a very common coexisting complaint), occipital nerve blocks provide targeted relief at the base of the skull and reduce headache frequency and severity.
Lumbar or Cervical Epidural Injections
In fibromyalgia patients who also have a structural component (disc disease, nerve root irritation), epidural injections reduce the peripheral pain input that amplifies central sensitization. Treating identifiable structural contributions often reduces overall fibromyalgia symptom burden.
Spinal Cord Stimulation (SCS)
For patients with severe, refractory fibromyalgia who have not responded to other treatments, emerging evidence supports spinal cord stimulation as an option — particularly for those with a predominantly regional pain distribution.
Sleep and Medication Coordination
Dr. Rubin works collaboratively with patients' primary care physicians and rheumatologists to optimize non-opioid medications for fibromyalgia (including SNRIs, alpha-2-delta ligands, and low-dose naltrexone) and to address the sleep disruption that is central to the condition.
Why Fibromyalgia Patients Often Need a Pain Specialist
Primary care physicians and rheumatologists diagnose fibromyalgia, but most are not equipped to offer the full range of interventional options that a pain specialist can provide. Dr. Rubin fills that gap — evaluating what structural, peripheral, or central factors may be driving symptoms, and offering targeted treatments beyond what oral medications alone can achieve.
FAQs About Fibromyalgia
Is fibromyalgia a real condition? Absolutely. Fibromyalgia is a recognized medical diagnosis with identifiable abnormalities in central pain processing, documented in neuroimaging and neurochemical research. It is not "all in your head" — though it does involve how the brain and spinal cord process pain.
Can fibromyalgia be cured? There is no known cure, but symptoms can be managed effectively. Many patients achieve significant improvement with the right combination of treatments, and some enter long periods of remission.
Is opioid therapy appropriate for fibromyalgia? Generally, no. Research consistently shows that opioids are ineffective for fibromyalgia and may worsen central sensitization over time. Dr. Rubin's approach is entirely non-opioid.
How quickly does ketamine help fibromyalgia? Many patients notice improvement during or after the infusion series (typically 4–6 sessions over 2 weeks). The full benefit often becomes apparent 2–4 weeks after completing the series. Booster infusions can maintain the effect over time.
Do I need a referral to see Dr. Rubin for fibromyalgia? No referral is required. Dr. Rubin accepts direct appointments and works collaboratively with your existing care team.
Treating Fibromyalgia on Long Island
Dr. Rubin sees patients at two convenient Nassau County locations — Garden City and Lake Success — with procedures performed at affiliated surgical centers including NYU Long Island and Northwell Health. Call 516-492-3100 to schedule your evaluation.