Fibromyalgia: a clinical review
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Updated: May 1, 2026
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Published on: January 5, 2024
1Professor of Anesthesiology, Medicine (Rheumatology), and Psychiatry and Director, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor.
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.
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