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Fibromyalgia

F. Stuart Leeds, MD, MS Reviewed 06/2020
 


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 American College of Radiology (ACR) criteria, still widely used: (i) pain in all four quadrants > 3 months, (ii) axial (neck/spine) involvement, (iii) tender points ≥11 (2)

  • 2...

TREATMENT

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

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, Häuser W. Fibromyalgia diagnosis and diagnostic criteria. Ann Med.  2011;43(7):495–502.
2
Wolfe F, Clauw DJ, Fitzcharles MA, et al. 2016 Revisions to the 2010/2011 fibromyalgia...

ADDITIONAL READING

  • Clauw DJ. Fibromyalgia: a clinical review. JAMA.  2014;311(15):1547–1555.

  • Sagy I, Bar-Lev Schleider L, Abu-Shakra M, et al. Safety and efficacy of medical cannabis in fibromyalg...

CODES

ICD10

M79.7 Fibromyalgia 

ICD9

729.1 Myalgia and myositis, unspecified 

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, fibr...

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