Key Points
ÎFibromyalgia is a heterogeneous chronic soft-tissue disorder marked by widespread musculoskeletal pain associated with headache, sleep disturbances, fatigue, and decreased stamina.1, 2
ÎFibromyalgia is the second most common disorder seen by rheumatologists, with a prevalence of 3.4% in women and 0.5% in men.1 become more likely with advancing age.
Fibromyalgia may ÎNon-restorative sleep is an essential part of the diagnosis.
ÎAmong the many other associated features of fibromyalgia are anxiety, depression, diffuse abdominal pain, variable bowel habits, and urinary frequency.4
(Table 4)
ÎCompared with controls, fibromyalgia patients show significantly higher levels of substance P and lower levels of serotonin, norepinephrine, and dopamine metabolites in cerebrospinal fluid (CSF).2
ÎThere is strong evidence that intensive patient education is an effective treatment in fibromyalgia syndrome. Pharmacotherapy for fibromyalgia syndrome has been most successful with central nervous system agents.1
ÎPain, fatigue, sleep, and global well-being are usually evaluated with 100-mm numerical rating scales or visual analog scales. Function is generally assessed by self-reported, validated instruments, most often the Fibromyalgia Impact Questionnaire (FIQ). The FIQ measures physical functioning, work status, depression, anxiety, morning tiredness, pain, stiffness, fatigue, and well-being during the preceding week.3
Patient Education
ÎExplain the diagnosis of fibromyalgia and the nature, course and prognosis of the condition.5
ÎAsk patients about their use of complementary products and practices, answer questions concerning efficacy, and identify possible negative interactions with prescribed treatment.5
ÎDiscuss medication side effects, particularly the possible increased risk of suicidal behavior and thinking among children, adolescents and young adults taking antidepressant medications.
ÎProvide strategies for daily activities.
