Fibromyalgia

F. Stuart Leeds, MD, MS Reviewed 06/2017
 


BASICS

DESCRIPTION

  • Chronic, widespread noninflammatory musculoskeletal pain syndrome with multisystem manifestations. Although the specific pathophysiology has not been elucidated, it is generally thou...

DIAGNOSIS

  • Original 1990 ACR criteria, still widely used: (i) pain in all four quadrants, (ii) axial (neck/spine) involvement, (iii) tender points (TPs) ≥11, (iv) no other explanation for symptoms 2

  • Per...

TREATMENT

According to the HHS National Guideline Summary 3 and other sources, evidence-based interventions include the following: 
  • Nonpharmacologic treatment critical to successful outcomes. It is vit...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • For efficacy of initial therapy: at 2- to 4-week intervals; then every 1 to 6 months, tailored to patient's needs

  • Advance exercise gradually to m...

REFERENCES

Wolfe  F, Häuser  W. Fibromyalgia diagnosis and diagnostic criteria. Ann Med.  2011;43(7):495–502. [View Abstract on OvidInsights]
Bennett  RM, Friend  R, Marcus  D, et al. Criteria f...

ADDITIONAL READING

Theadom A, Cropley M, Smith HE, et al. Mind and body therapy for fibromyalgia. Cochrane Database Syst Rev.  2015;(4):CD001980.  

SEE ALSO

Algorithm: Fatigue 

CODES

ICD10

M79.7 Fibromyalgia 

ICD9

729.1 Myalgia and myositis, unspecified 

SNOMED

  • 24693007 Fibromyositis (disorder)

  • 95417003 primary fibromyalgia syndrome (disorder)

CLINICAL PEARLS

  • Use rigorous ACR criteria to make the diagnosis.

  • Fibromyalgia is not a somatoform disorder and is not merely a manifestation of depression or anxiety, although as with all chronic pain ...

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