Fibromyalgia Syndrome (Oxford Rheumatology Library)

Fibromyalgia Syndrome (Oxford Rheumatology Library)

Ernest Choy

Print publication date: Nov 2015

ISBN: 9780198723233

Publisher: Oxford University Press

Abstract

Fibromyalgia syndrome is a common condition afflicting 2–5% of the population. It is commoner in females than males. The dominant symptom is chronic widespread pain. However, fatigue, sleep disturbance, depression, anxiety, stiffness, and cognitive dysfunction are also common. The American College of Rheumatology in 1990, 2010, and 2011 published classification and diagnostic criteria for fibromyalgia syndrome. Although they were primarily designed for research, these criteria have been commonly used in routine clinical practice. One of the characteristic clinical findings in fibromyalgia syndrome is ‘tenderness’ on mild pressure/palpation. This is a manifestation of allodynia—pain caused by subnoxious stimuli. The major pathophysiology that underpins allodynia is central sensitization, in which alterations in the nociceptive system within the central nervous system cause pain to be amplified. Research with modern neuroimaging techniques, such as functional magnetic resonance scan, showed that pain is ‘real’ in patients with fibromyalgia syndrome. Many national and international societies recognizing the healthcare burden of fibromyalgia syndrome have published recommendations/guidelines on diagnosis and management. They emphasized the importance of a positive diagnosis and management strategy to empower patients to cope with fibromyalgia syndrome. Importantly, treatment of fibromyalgia syndrome should be tailored to the individual patient, addressing their particular needs and additional symptoms other than pain. In most patients, it involves a combination of education, and non-pharmacological and pharmacological treatments. Although these treatments are not curative, they improve symptoms and quality of life that benefit not only patients, but also healthcare providers and society.