Fibromyalgia in the elderly: differential diagnosis and treatment

Fibromyalgia in the elderly often occurs in the presence of other musculoskeletal disorders where it is often unsuspected. The clue to the diagnosis of concomitant fibromyalgia lies in the widespread distribution of the pain and in its severity. All patients with this disorder have multiple, symmetrically distributed "tender points," a physical sign which is specific for fibromyalgia. Treatment includes, first, explanation. Aerobic exercise may be helpful in many patients, and administration of tricyclic compounds in very low doses is often effective in treating the associated sleep disorder and in reducing overall disease severity.