Fibromyalgia Overview
Overview
Chronic pain and fatigue syndromes such as fibromyalgia represent part of a clinical spectrum of overlapping disorders that afflict a significant portion of the general population. Data suggest that there is a familial tendency to develop these disorders, and that exposure to physical, emotional or environmental stressors may trigger initiation of symptoms. Once the illness develops, the majority of symptoms are likely mediated by central nervous system mechanisms. Overlapping co-morbid conditions such as chronic fatigue syndrome, multiple chemical sensitivity, irritable bowel syndromes, and tension and migraine headache are common, and in many cases will respond to similar interventions. In contrast, mimicking disorders such as Hepatitis C, hypothyroidism, polymyalgia and particularly autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosis need to be differentiated, as the treatments for inflammatory disorders are not useful in the management of fibromyalgia.
Management strategies are similar to those implemented in response to other chronic illnesses. An empathetic health care provider should develop a partnership with the patient and various treatments should be tried, preferably one at a time. Those treatments that are most effective should then be continued. In routine clinical practice, non-pharmacologic therapies are probably underutilized. Hopefully, identifying conditions early and intervening before chronicity leads to dysfunction and disability will lead to far less frustration and improved physical functioning for patients.
