Fibromyalgia: diagnosis and management for the primary healthcare provider

J Womens Health (Larchmt). 2008 Oct;17(8):1379-87. doi: 10.1089/jwh.2007.0656.

Abstract

Fibromyalgia is a disorder of chronic generalized musculoskeletal pain affecting 2% of the general population, with an increased frequency in women. Clinical diagnosis relies on history and research-supported tender point criteria. As in other chronic pain syndromes, a multidimensional approach optimizes treatment response. Empirical data and consensus support the use of nonpharmacological modalities, such as education, aerobic exercise, and cognitive behavioral therapy, in the management of fibromyalgia. Evidence-supported pharmacological interventions include tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, selective serotonin reuptake inhibitors, alpha-2-delta ligands, and other serotonergic-noradrenergic analgesic agents, such as tramadol. This paper offers the primary healthcare provider a systematic approach to the diagnosis of fibromyalgia and management strategies based on available evidence, consensus, and empirical data.

MeSH terms

  • Antidepressive Agents / administration & dosage
  • Comorbidity
  • Evidence-Based Medicine
  • Exercise
  • Fibromyalgia / diagnosis*
  • Fibromyalgia / therapy*
  • Humans
  • Pain / drug therapy
  • Primary Health Care
  • Serotonin Agents / administration & dosage

Substances

  • Antidepressive Agents
  • Serotonin Agents