Fibromyalgia syndrome: a comprehensive approach to identification and management

Fibromyalgia syndrome (FMS) is a common, chronic musculoskeletal pain disorder of unknown etiology seen predominately in women. It is recognized as an important clinical problem associated with high levels of functional disability, emotional distress, and utilization of several types of medical services. While widespread pain and the presence of multiple tender points characterize the dominating features, there are a large number of nonrheumatic symptoms and associated conditions that occur in a high frequency in this disorder. When the characteristic pattern of symptoms is recognized, FMS can be successfully managed by nurse practitioners with expectation of some improvement. The mainstays of management include patient education, medication, aerobic exercise, and physical therapy. An ongoing relationship with the patient and periodic follow-up are mandatory.