Fibromyalgia: diagnosis and management for the primary healthcare provider.
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.
Huynh
Christine N
CN
Division of General Internal Medicine, Virginia Commonwealth University, Richmond, Virginia 23298, USA. chuynh@mcvh-vcu.edu
Yanni
Leanne M
LM
Morgan
Laura A
LA
D000928:Antidepressive Agents / Q000008:administration & dosage; D015897:Comorbidity; D019317:Evidence-Based Medicine; D015444:Exercise; D005356:Fibromyalgia / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D010146:Pain / Q000188:drug therapy; D011320:Primary Health Care; D018490:Serotonin Agents / Q000008:administration & dosage
D000928:Antidepressive Agents; D018490:Serotonin Agents