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Fibromyalgia

F. Stuart Leeds, MS, MD Reviewed 06/2022
 


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 (1)

  • 2010-11 ACR criteria, revised in...

TREATMENT

Evidence-based interventions: 
  • Includes both medication and nonpharmacologic interventions. In general, a partial or complete remission can only be achieved with committed changes in lifestyl...

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

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. [Vie...

ADDITIONAL READING

  • Bazzichi L, Giacomelli C, Consensi A, et al. One year in review 2020: fibromyalgia. Clin Exp Rheumatol. 2020 Jan-Feb;38 Suppl 123(1):3-8.

  • Lo...

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 central sensitization; it is not a somatoform disorder and is not merely a manifestation of depression or anxiety. As with all chronic pain syndromes, howe...

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