Fibromyalgia
Background
- A disorder of pain regulation, sometimes classified as a kind of central sensitization
- Chronic musculoskeletal pain not explained by another systemic disorder
- More common in women than men
Clinical Features
- Chronic musculoskeletal pain
- Insomnia
- Fatigue
- Decreased concentration
- Headache
- Paresthesias
Differential Diagnosis
- Rheumatoid arthritis
- Sjögren Syndrome
- Systemic lupus erythematosus
- Ankylosing spondylitis
- Myopathies: metabolic or statin-induced
- Myasthenia gravis
- Myofascial pain syndrome
- Multiple sclerosis
- Psychiatric disorders
Evaluation
- Clinical diagnosis
Management
- Tricyclic antidepressants
- Select SNRIs (duloxetine, venlafaxine, milnacipran)
- Anticonvulsants (pregabalin, gabapentin)
- Exercise program
Disposition
- Discharge