Fibromyalgia: current diagnosis and management

Fibromyalgia is a common disorder occurring in approximately 2-5% of most populations, with female patients outnumbering males by up to nine to one. The two essential components of fibromyalgia, experienced in conjunction, are widespread pain and widespread abnormal bodily tenderness, although other common features of the syndrome include fatigue, muscle stiffness, poor-quality sleep and emotional distress. The clinical features result from complex changes of pain-related neurophysiological function in the brain and spinal cord, particularly through the neurophysiological process of sensitization. Management of fibromyalgia is directed to the inputs to this process, through a combination of education, exercise and psychological strategies. A number of drugs can also target this mechanism. With use of selected combinations of these strategies, the prognosis of fibromyalgia is now much improved.