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Fibromyalgia

Frederic Stuart Leeds, MS, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

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

DIAGNOSIS

  • Original 1990 ACR criteria, still widely used: (i) pain in all four quadrants >3 months, (ii) axial (neck/spine) involvement, (iii) tender points ≥11

  • 2010–11 ACR criteria, revised in 2016 ...

TREATMENT

Evidence-based interventions: 
  • Includes both medication and nonpharmacologic interventions (2). A multimodal approach using safe combinations of mutually-reinforcing therapies, both pharmaco...

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 and ...

REFERENCES

1
Wolfe F, Clauw DJ, Fitzcharles MA, et al. 2016 revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum. 2016;46(3):319–329.
2
Macfarlane GJ, Kronisch C, Dean LE, e...

ADDITIONAL READING

  • Häuser W, Fitzcharles M. Facts and myths pertaining to fibromyalgia, Dialogues Clin Neurosci. 2018;20(1):53–62, doi: 10.31887/DCNS.2018.20.1/whauser

  • ...

SEE ALSO

Algorithm: Fatigue 

CODES

ICD10

M79.7 Fibromyalgia 

SNOMED

  • 24693007 Fibromyositis (disorder)

  • 95417003 primary fibromyalgia syndrome (disorder)

CLINICAL PEARLS

  • Fibromyalgia is a disease of nociplastic pain and central sensitization. It is not a somatoform disorder, and is not merely a manifestation of depression or anxiety. As with all chroni...

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