Fibromyalgia is a chronic and complex disease of unknown aetiology, characterised by widespread chronic musculoskeletal pain, with exaggerated hypersensitivity in multiple areas of the body and predefined points (‘tender points’). The symptoms are wide-ranging, the most common being fatigue and sleep disturbances, but also including numbness or tingling in the extremities, stiffness, headache, anxiety and depression, and problems with attention, concentration and memory, among others. Fibromyalgia is not only chronic, but the intensity of the symptoms can also change over time and occur in flare-ups. It is more common in women.
The diagnosis is clinical, based on questioning and physical examination. Other diseases of hormonal, rheumatological, neuromuscular, infectious, neurological and psychiatric causes must first be ruled out to confirm the diagnosis of fibromyalgia.
Other central sensitivity disorders are often associated with fibromyalgia, such as irritable bowel syndrome and restless legs syndrome, as well as anxiety, depression, and rheumatic diseases such as arthritis and osteoarthritis.
Multidisciplinary treatment is recommended, including:
1. Pharmacological treatment to alleviate pain and psychiatric treatment with anxiolytics and antidepressants.
2. Non-pharmacological treatment: cognitive behavioural therapy and physical therapies (aerobic exercise, stretching, muscle toning).
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- Schmidt-Wilcke T, Kairys A, Ichesco E, et al. Changes in clinical pain in fibromyalgia patients correlate with changes in brain activation in the cingulate cortex in a response inhibition task. Pain Med 2014; 15:1346.
- Clauw DJ. Fibromyalgia: a clinical review. JAMA 2014; 311:1547.
