Related Experiment Video
Updated: Oct 29, 2025
Author Spotlight: Methodologies and Advancements of Chronic Pain Management Research
Published on: January 5, 2024
Fibromyalgia in Older Individuals
Amir Minerbi1,2, Mary-Ann Fitzcharles3,4
1Institute for Pain Medicine, Rambam Health Campus, Haifa, Israel.
Abstract:
Fibromyalgia (FM) is a condition of chronic widespread pain (CWP) that can occur throughout the life cycle and is likely underrecognized in older patients. FM is associated with considerable suffering and reduction in quality of life and may occur as a unique condition, but in older patients is most likely to be associated with another medical illness. Understood mechanistically to be a sensitization of the nervous system, recently identified as nociplastic pain, FM is accepted as a valid medical illness that requires a positive diagnosis and directed treatments. The cornerstone of treatments for FM are nonpharmacologic interventions, with the understanding that medications provide only modest benefit for most patients, and with particular concern about adverse effects in older patients. If FM is not recognized, treatments may be misdirected to the other medical condition, with failure to address FM symptoms, leading to overall poor outcome. In contrast, new complaints in older patients should not immediately be attributed to FM, and physicians should be vigilant to ensure that onset of a new illness is not ignored. As FM is most often a lifelong condition, patients should be encouraged to identify their own personal strategies that can attenuate symptoms, especially when symptoms flare. Continued life participation should be the outcome goal.
Insights
Fibromyalgia (FM), a chronic widespread pain condition, is often underrecognized in older adults. Early diagnosis and non-pharmacologic treatments are crucial for managing this nociplastic pain and improving quality of life.
Area of Science:
- Rheumatology
- Pain Medicine
- Geriatrics
Background:
- Fibromyalgia (FM) is a chronic widespread pain (CWP) condition impacting quality of life.
- It is often underrecognized in older populations and may coexist with other medical illnesses.
- FM is characterized by nervous system sensitization, now termed nociplastic pain.
Purpose of the Study:
- To highlight the importance of recognizing and diagnosing Fibromyalgia in older patients.
- To emphasize non-pharmacologic interventions as the cornerstone of FM treatment.
- To caution against misattributing new symptoms in older adults solely to FM.
Main Methods:
- Review of current understanding of Fibromyalgia pathophysiology and clinical presentation.
- Discussion of diagnostic considerations, particularly in the geriatric population.
- Analysis of treatment strategies, emphasizing non-pharmacologic approaches.
Main Results:
- Fibromyalgia is a valid diagnosis requiring directed treatment.
- Non-pharmacologic interventions are preferred over pharmacologic options due to modest benefits and potential adverse effects in older adults.
- Accurate diagnosis is essential to avoid misdirected treatments and ensure optimal patient outcomes.
Conclusions:
- Early recognition and diagnosis of Fibromyalgia in older adults are critical.
- Non-pharmacologic therapies should be prioritized for managing FM symptoms.
- Physicians must maintain vigilance for new illnesses in older patients, avoiding premature attribution to FM.
Related Concept Videos
01:22Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
01:15Drug Dosing: Geriatric Patients
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:00Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion