Update on fibromyalgia

Introduction: Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread pain, fatigue, sleep alterations, and distress. It affects at least 2% of the adult population. The etiology of FM is not completely understood, and the syndrome is influenced by stress, physical illness, and a variety of pain conditions. Emerging evidence indicates that augmented pain processing within the central nervous system plays a primary role in the pathophysiology of this disorder. Diagnosis may be difficult because of the multifaceted nature of the syndrome and its overlap with other chronically painful conditions. This article reviews the most recent data in the literature on FM. Materials and methods: There are currently no instrumental tests or specific diagnostic markers for FM. In fact, many of the existing indicators are regarded as significant for research purposes only. Results: Differential diagnosis requires an extensive clinical examination and complete patient history. Chest-X-rays and abdominal ultrasonography are the first steps in the general evaluation of a patient with suspected FM. Conclusions: A variety of pharmacological treatments have been used to treat FM, including antidepressants, nonsteroidal anti-inflammatory drugs, opioids, sedatives, muscle relaxants, and antiepileptics. Physical exercise and multimodal cognitive-behavioral therapy seem to be the most widely accepted and beneficial forms of non-pharmacological therapy. (C) 2011 Elsevier Srl. All rights reserved.