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Pain and the brain: chronic widespread pain
1Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
The Journal of Clinical Psychiatry
|May 1, 2009
Summary
Chronic widespread pain often links to various medical and psychiatric conditions. Effective fibromyalgia management requires careful diagnosis and a comprehensive strategy including education, medication, therapy, and exercise.
Area of Science:
- Rheumatology
- Psychiatry
- Endocrinology
Background:
- Chronic widespread pain is a complex symptom linked to numerous medical and psychiatric conditions.
- Conditions include chronic fatigue syndrome, fibromyalgia, mood disorders, hypothyroidism, and rheumatoid arthritis.
- Fibromyalgia presents diagnostic challenges due to overlapping symptoms and frequent co-occurrence with mood disorders.
Purpose of the Study:
- To highlight the importance of differential diagnosis for chronic widespread pain.
- To emphasize the diagnostic and therapeutic complexities of fibromyalgia.
- To outline a comprehensive disease management approach for fibromyalgia.
Main Methods:
- Review of conditions associated with chronic widespread pain.
- Discussion of diagnostic challenges in fibromyalgia.
- Description of a multimodal management strategy for fibromyalgia.
Main Results:
- Chronic widespread pain is associated with a broad spectrum of disorders.
- Accurate differential diagnosis is crucial for effective treatment selection.
- Fibromyalgia diagnosis is complicated by shared features with other conditions and high comorbidity with mood disorders.
Conclusions:
- A thorough differential diagnosis is essential for patients with chronic widespread pain.
- Comprehensive management of fibromyalgia should integrate patient education, pharmacotherapy, cognitive-behavioral therapy, and exercise.
- Multidisciplinary approaches can improve outcomes for fibromyalgia patients.
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