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Treatment of fibromyalgia in adults

INTRODUCTION

Fibromyalgia is a chronic pain disorder that is difficult to treat. It is most important to educate the patient and family regarding the uncertainty involved in pathogenesis, diagnosis, and treatment [1]. There is no test that confirms this diagnosis, which is currently based upon the following clinical criterion [1]:

  • Widespread musculoskeletal pain
  • Excess tenderness in at least 11 of 18 predefined anatomic sites (figure 1)

The treatment of fibromyalgia will be reviewed here. Patients with fibromyalgia generally respond best to a multidisciplinary treatment program that incorporates physician as well as non-physician providers [2]. This includes a team of physical medicine, rehabilitation, and mental health specialists.

Other issues related to fibromyalgia, including clinical manifestations, diagnosis, the differential diagnosis of widespread pain, pathogenesis, and fibromyalgia in children, and pathogenesis are discussed separately. (See "Clinical manifestations and diagnosis of fibromyalgia in adults" and "Differential diagnosis of fibromyalgia"," and (see "Pathogenesis of fibromyalgia" and "Clinical manifestations and diagnosis of fibromyalgia in children and adolescents".

PATIENT EDUCATION

Patients with fibromyalgia (as well as those with the myofascial pain syndrome and the chronic fatigue syndrome) need to understand their illness before any medications are prescribed [2,3] (see 'Information for patients' below.
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