Daniel J Clauw1. 1. Professor of Anesthesiology, Medicine (Rheumatology), and Psychiatry and Director, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor.
Abstract
IMPORTANCE: Fibromyalgia is present in as much as 2% to 8% of the population, is characterized by widespread pain, and is often accompanied by fatigue, memory problems, and sleep disturbances. OBJECTIVE: To review the epidemiology, pathophysiology, diagnosis, and treatment of fibromyalgia. EVIDENCE REVIEW: The medical literature on fibromyalgia was reviewed from 1955 to March 2014 via MEDLINE and the Cochrane Central Registry of Controlled Trials, with an emphasis on meta-analyses and contemporary evidence-based treatment guidelines. Treatment recommendations are based on the most recent evidence-based guidelines from the Canadian Pain Society and graded from 1 to 5 based on the level of available evidence. FINDINGS: Numerous treatments are available for managing fibromyalgia that are supported by high-quality evidence. These include nonpharmacological therapies (education, exercise, cognitive behavioral therapy) and pharmacological therapies (tricyclics, serotonin norepinephrine reuptake inhibitors, and gabapentinoids). CONCLUSIONS AND RELEVANCE: Fibromyalgia and other "centralized" pain states are much better understood now than ever before. Fibromyalgia may be considered as a discrete diagnosis or as a constellation of symptoms characterized by central nervous system pain amplification with concomitant fatigue, memory problems, and sleep and mood disturbances. Effective treatment for fibromyalgia is now possible.
IMPORTANCE: Fibromyalgia is present in as much as 2% to 8% of the population, is characterized by widespread pain, and is often accompanied by fatigue, memory problems, and sleep disturbances. OBJECTIVE: To review the epidemiology, pathophysiology, diagnosis, and treatment of fibromyalgia. EVIDENCE REVIEW: The medical literature on fibromyalgia was reviewed from 1955 to March 2014 via MEDLINE and the Cochrane Central Registry of Controlled Trials, with an emphasis on meta-analyses and contemporary evidence-based treatment guidelines. Treatment recommendations are based on the most recent evidence-based guidelines from the Canadian Pain Society and graded from 1 to 5 based on the level of available evidence. FINDINGS: Numerous treatments are available for managing fibromyalgia that are supported by high-quality evidence. These include nonpharmacological therapies (education, exercise, cognitive behavioral therapy) and pharmacological therapies (tricyclics, serotonin norepinephrine reuptake inhibitors, and gabapentinoids). CONCLUSIONS AND RELEVANCE: Fibromyalgia and other "centralized" pain states are much better understood now than ever before. Fibromyalgia may be considered as a discrete diagnosis or as a constellation of symptoms characterized by central nervous system pain amplification with concomitant fatigue, memory problems, and sleep and mood disturbances. Effective treatment for fibromyalgia is now possible.
Authors: Gita Fatemi; Meika A Fang; Paula Breuer; Paul E Cherniak; Angela Gentili; Joseph T Hanlon; Jordan F Karp; Natalia E Morone; Eric Rodriguez; Michelle I Rossi; Kenneth Schmader; Debra K Weiner Journal: Pain Med Date: 2015-08-14 Impact factor: 3.750
Authors: Chad M Brummett; Jennifer F Waljee; Jenna Goesling; Stephanie Moser; Paul Lin; Michael J Englesbe; Amy S B Bohnert; Sachin Kheterpal; Brahmajee K Nallamothu Journal: JAMA Surg Date: 2017-06-21 Impact factor: 14.766
Authors: Brandon Pleman; Michelle Park; Xingyi Han; Lori Lyn Price; Raveendhara R Bannuru; William F Harvey; Jeffrey B Driban; Chenchen Wang Journal: Clin Rheumatol Date: 2019-01-14 Impact factor: 2.980