Fibromyalgia Questions & Answers

Updated: Nov 14, 2018
  • Author: Chad S Boomershine, MD, PhD, CPI, CPT; Chief Editor: Herbert S Diamond, MD  more...
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Questions & Answers

Overview

What is fibromyalgia?

What are the signs and symptoms of fibromyalgia?

What are the diagnostic considerations in fibromyalgia?

Which lab tests are used in the workup of fibromyalgia?

Which patient questionnaires are used in the diagnosis of fibromyalgia?

Which psychometric tests are used in the diagnosis of fibromyalgia?

How is fibromyalgia managed?

Which nonpharmacologic techniques are used in the management of fibromyalgia?

Which medications are used in the treatment of fibromyalgia?

Which medications may help sleep problems in fibromyalgia that does not respond to other treatments?

Which OTC drugs are used to treat fibromyalgia?

How is fibromyalgia characterized?

Which syndromes overlap with fibromyalgia?

What is required to successfully care for patients with fibromyalgia?

What is involved in the management of fibromyalgia?

What is the historical background on fibromyalgia?

How often is fibromyalgia correctly diagnosed?

What is the nomenclature for fibromyalgia?

What is the pathophysiology of fibromyalgia?

How is pain defined in the pathophysiology of fibromyalgia?

Which factors influence how pain is perceived in patients with fibromyalgia?

What is the role of negative emotions in the intensity of pain experienced in fibromyalgia?

What are the biological elements in the pathophysiology of pain in fibromyalgia?

Where does pain derive from in the pathophysiology of fibromyalgia?

What abnormalities in pain processing have been demonstrated in fibromyalgia?

What is the role of single-nucleotide polymorphism (SNP) haplotypes in the pathophysiology of pain in fibromyalgia?

How do drugs reduce pain in fibromyalgia?

What is the role of biochemical changes in the CNS in the pathophysiology of fibromyalgia?

Why does increased pain sensitivity occur in women with fibromyalgia?

Which central processes play a role in the pathophysiology of fibromyalgia?

What is the role of serotonin in the pathophysiology of fibromyalgia?

What is the role of substance P in the pathophysiology of fibromyalgia?

What is the role of adenosine triphosphate (ATP) in the pathophysiology of fibromyalgia?

What is the importance of the hypothalamic-pituitary-adrenal (HPA) axis in the pathophysiology of fibromyalgia?

Which neuroendocrine abnormalities are associated with hypothalamic-pituitary-adrenal (HPA) axis dysfunction in fibromyalgia?

What is the role of serotonin in the hypothalamic-pituitary-adrenal (HPA) axis dysfunction in fibromyalgia?

What is the role of growth hormone in the pathophysiology of fibromyalgia?

What is the role of the nerve growth factor in the pathophysiology of fibromyalgia?

What is the cognitive impact of fibromyalgia?

What does fMRI reveal about the pathophysiology of fibromyalgia?

What causes cognitive dysfunction in fibromyalgia?

How is sleep dysfunction characterized in patients with fibromyalgia?

What are the basic patterns of normal sleep relative to understanding abnormal sleep architecture in fibromyalgia?

What occurs during the REM stage of sleep relative to understanding abnormal sleep patterns in fibromyalgia?

What is the role of altered NREM sleep in the pathophysiology of fibromyalgia?

What is the role of sleep dysfunction in the pathophysiology of fibromyalgia?

Which primary sleep disorders may affect sleep quality in patients with fibromyalgia?

What causes fibromyalgia?

What biologic variables contribute to the development of fibromyalgia?

What is the role of genetics in the development of fibromyalgia?

What are the sex-related effects in fibromyalgia?

What is the role of abnormal sleep in the development of fibromyalgia?

What is the role of trauma in the development of fibromyalgia?

What is the role of stress response system dysregulation in the etiology of fibromyalgia?

What other variables play a role in the etiology of fibromyalgia?

Which variables have an uncertain relationship to the development of fibromyalgia?

Which psychological variables are implicated in the etiology of fibromyalgia?

What is the role of meaning structures in the etiology of fibromyalgia?

What are the consequences of negative beliefs associated with fibromyalgia?

What is the role of negative beliefs in the etiology of fibromyalgia?

What is the role of hypervigilance in the etiology of fibromyalgia?

What is the role of perceived self-efficacy in the etiology of fibromyalgia?

Which areas of the brain are involved in pain perception in fibromyalgia?

Which psychiatric comorbidities are associated with fibromyalgia?

How do pressure-pain thresholds correlate with psychological comorbidity in patients with fibromyalgia?

What is the role of depression in the etiology of fibromyalgia?

What is the role of personality traits in the etiology of fibromyalgia?

What is the role of pain behaviors in the etiology of fibromyalgia?

What is the role of environmental and sociocultural variables in the etiology of fibromyalgia?

What is the role of developmental variables in the etiology of fibromyalgia?

What is the role of family and work variables in the etiology of fibromyalgia?

What sociocultural factors play a role in the etiology of fibromyalgia?

What is the prevalence of fibromyalgia?

What is the prevalence of fibromyalgia in the US?

What is the international prevalence of fibromyalgia?

What are the race-related differences in the incidence of fibromyalgia?

What are the sex-related differences in the incidence of fibromyalgia?

Which mechanisms may contribute to increased pain sensitivity in women with fibromyalgia?

What are the age-related differences in the incidence of fibromyalgia?

What is the prognosis of fibromyalgia?

How are patients with fibromyalgia categorized?

Which patient characteristics are associated with a guarded prognosis in fibromyalgia?

What is the prognosis of fibromyalgia without proper and diagnosis and treatment?

How does fibromyalgia affect the quality of social and economic life?

What are the risks of death from suicide in patients with fibromyalgia?

What is involved in patient education for fibromyalgia?

What educational resources are available on fibromyalgia?

Presentation

How is fibromyalgia characterized and diagnosed?

What are the diagnostic criteria for fibromyalgia?

Which scales are used in the ACR diagnostic criteria for fibromyalgia?

What is the widespread pain index (WPI) in the diagnostic criteria for fibromyalgia?

What is the symptom severity (SS) scale in the diagnostic criteria for fibromyalgia?

Which conditions meet the criteria for a definitive diagnosis of fibromyalgia?

How is symptom severity determined in fibromyalgia?

What does a self-administered patient questionnaire on fibromyalgia assess?

How are self-administered patient questionnaires on fibromyalgia scored?

What are the goals of the physical exam for fibromyalgia?

What is the manual tender-point survey (MTPS) method in the physical exam of fibromyalgia?

How is the manual tender-point survey (MTPS) performed in the physical exam for fibromyalgia?

How is the manual tender-point survey (MTPS) scored in the physical exam of fibromyalgia?

What are the standard fibromyalgia tender points?

What are the specific locations of tender points on the anterior body in fibromyalgia?

What are the specific locations of tender points on the posterior body in fibromyalgia?

What are the benefits of using pressure algometry in fibromyalgia?

What evaluations other than tender point assessment are indicated in the physical exam for fibromyalgia?

What are the potential complications of fibromyalgia?

DDX

What are the diagnostic considerations for fibromyalgia?

What other problems should be considered in the differential diagnosis of fibromyalgia?

What is the Fibromyalgia Rapid Screening Tool (FiRST)?

What are the differential diagnoses for Fibromyalgia?

Workup

What are the approach considerations in the workup of fibromyalgia?

When is erythrocyte sedimentation rate (ESR) testing indicated in the workup of fibromyalgia?

When is antinuclear antibody (ANA) or rheumatoid factor (RF) testing indicated in the workup of fibromyalgia?

What are the benefits of formal sleep studies in the workup of fibromyalgia?

What are the benefits of serum transferrin saturation and serum ferritin screening in the workup of fibromyalgia?

How is the antipolymer antibody assay used in the workup of fibromyalgia?

What is the role of histology in the workup of fibromyalgia?

What is the recommended approach to the workup for fibromyalgia?

What are the benefits of self-assessments in the workup of fibromyalgia?

What is involved in psychometric testing in the workup of fibromyalgia?

Treatment

How should physicians inform patients with fibromyalgia regarding treatment?

What are the EULAR guidelines for the initial management of fibromyalgia?

What are the therapeutic recommendations for the management of fibromyalgia?

How should physicians approach the discussion of a fibromyalgia diagnosis with a patient?

What should be avoided in the treatment of fibromyalgia?

How is chronic pain managed in fibromyalgia?

When is medication indicated in the management of fibromyalgia?

What is the efficacy of multicomponent treatment of fibromyalgia?

How does poor sleep affect fibromyalgia?

What medical therapies can be effective for pain management in fibromyalgia?

What is the relationship between Chiari malformation and fibromyalgia?

What is involved in the treatment of children with fibromyalgia?

What are some tips for avoiding and managing flare-ups in fibromyalgia?

What is involved in psychological and behavioral therapy for the treatment of fibromyalgia?

What are the treatment options for depression in fibromyalgia?

What is the role of physical exercise in the management of fibromyalgia?

What are the benefits of exercise in patients with fibromyalgia?

Which physical modalities in addition to exercise may be beneficial to patients with fibromyalgia?

What is involved in the treatment of fibromyalgia?

What are considerations regarding pharmacologic therapy for fibromyalgia?

Which drugs have been approved for use in fibromyalgia?

How effective is drug treatment for fibromyalgia?

What pharmacologic options are available for fibromyalgia?

Which medications should be avoided or used with caution in the treatment of fibromyalgia?

How effective are analgesics in the treatment of fibromyalgia?

How are patients with fibromyalgia tapered off opioid medications?

Which antianxiety drugs are used in the treatment of fibromyalgia?

What are the benefits of antidepressants in the treatment of fibromyalgia?

Which antidepressants have been approved for use in fibromyalgia?

Which combination of antidepressants are effective for the treatment of fibromyalgia?

Which antidepressants with 5-HT1 receptor agonist activity are available for the treatment of fibromyalgia?

How are anticonvulsants used for the treatment of fibromyalgia?

What second-line medications are used in the treatment of fibromyalgia?

How are sleep problems addressed in the management of fibromyalgia?

Which medications are available to improve sleep in patients with fibromyalgia?

What dietary recommendations are indicated in the management of fibromyalgia?

How does a poor diet affect patients with fibromyalgia?

What are the dietary recommendations for patients with fibromyalgia?

What is the role of dietary antioxidants in the treatment of fibromyalgia?

What other dietary measures are used in fibromyalgia?

Which specialist consultations are indicated in the treatment of fibromyalgia?

What is involved in the follow-up care of patients with fibromyalgia?

What is the role of integrative medicine in the treatment of fibromyalgia?

Guidelines

What are the guidelines on the treatment of fibromyalgia?

Medications

What are the goals of drug treatment for fibromyalgia?

Which medications in the drug class Analgesics are used in the treatment of Fibromyalgia?

Which medications in the drug class Antianxiety Agents are used in the treatment of Fibromyalgia?

Which medications in the drug class Skeletal Muscle Relaxants are used in the treatment of Fibromyalgia?

Which medications in the drug class Antidepressants are used in the treatment of Fibromyalgia?

Which medications in the drug class Anticonvulsants are used in the treatment of Fibromyalgia?

Which medications in the drug class Alpha2 Agonists are used in the treatment of Fibromyalgia?