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Fibromyalgia

F. Stuart Leeds, MD, MS Reviewed 06/2018
 


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)

  • 2...

TREATMENT

Evidence-based interventions include (3): 
  • Nonpharmacologic treatment are central to successful outcomes. Patients should be active participants in their care, especially with exercise and li...

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. [View Abstract on OvidMedline]
2
Bennett RM, Friend R, Marcus D, et al. Criteria for th...

ADDITIONAL READING

  • Theadom A, Cropley M, Smith HE, et al. Mind and body therapy for fibromyalgia. Cochrane Database Syst Rev.  2015;(4):CD001980. [View Abstract on OvidMedline]

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 ACR criteria to make the formal diagnosis.

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

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