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Fibromyalgia: a clinical review.

Daniel J Clauw1

  • 1Professor of Anesthesiology, Medicine (Rheumatology), and Psychiatry and Director, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor.

JAMA
|April 17, 2014
PubMed
Summary

Effective fibromyalgia treatment is now possible, with nonpharmacological and pharmacological options supported by high-quality evidence. This review covers fibromyalgia

Area of Science:

  • Rheumatology and Pain Management
  • Centralized Pain Syndromes

Background:

  • Fibromyalgia affects 2-8% of the population, characterized by widespread pain, fatigue, memory, and sleep issues.
  • Understanding of fibromyalgia and other centralized pain states has significantly advanced.

Purpose of the Study:

  • To review the epidemiology, pathophysiology, diagnosis, and treatment of fibromyalgia.
  • To provide evidence-based treatment recommendations for fibromyalgia management.

Main Methods:

  • Comprehensive literature review of fibromyalgia from 1955 to March 2014.
  • Emphasis on meta-analyses and evidence-based treatment guidelines from the Canadian Pain Society.
  • Treatment recommendations graded from 1 to 5 based on evidence level.

Main Results:

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  • Numerous effective treatments for fibromyalgia are supported by high-quality evidence.
  • Recommended therapies include nonpharmacological (education, exercise, CBT) and pharmacological (TCAs, SNRIs, gabapentinoids) options.

Conclusions:

  • Fibromyalgia is understood as a distinct diagnosis or a symptom cluster involving central nervous system pain amplification.
  • Effective management strategies for fibromyalgia are now available, improving patient outcomes.