Coupon Accepted Successfully!


Fibromyalgia (FM)

  1. FM is characterized by chronic widespread musculoskeletal pain and tenderness.
  2. FM is far more common in women than in men, with a ratio of about 9:1.
  3. Pain and Tenderness
  4. The most common presenting complaint of a patient with FM is "pain all over." Patients with FM have pain that is typically above and below the waist on both sides of the body and involves the axial skeleton (neck, back, or chest).
  5. The pain attributable to FM is poorly localized, difficult to ignore, severe in its intensity, and associated with a reduced functional capacity. Pain should have been present most of the day on most days for at least 3 months.
  6. The clinical pain of FM is associated with increased evoked pain sensitivity. This is determined by a tender points examination in which the examiner uses the thumbnail to exert pressure.
  7. 11 out of 18 sites should be perceived as painful for a diagnosis of FM.
  8. In addition to widespread pain, FM patients typically complain of fatigue, stiffness, sleep disturbance, cognitive dysfunction, anxiety, and depression.
Table 335-3 Pharmacologic Agents Effective for Treatment of Fibromyalgia
Antidepressants: (Balanced serotonin & norepinephrine reuptake inhibition)
  1. Amitriptyline
  2. Duloxetine
  3. Milnacipran
Anticonvulsants: (ligands of the alpha-2-delta subunit of voltage-gated calcium channels)
  1. Gabapentin
  2. Pregabalin

Test Your Skills Now!
Take a Quiz now
Reviewer Name