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[Fibromyalgia syndrome - updated s3 guidelines].
Z Orthop Unfall. 2013 Dec; 151(6):603-9.ZO

Abstract

Patients with chronic widespread pain often present with musculo-skeletal pain and therefore often initially contact an orthopaedist. For these patients fibromyalgia syndrome is an important differential diagnosis. Recommendations for the diagnosis of and therapy for fibromyalgia syndrome based on the recent German S3 guidelines for fibromyalgia syndrome (AWMF registration number 041/004) are outlined in this paper. These guidelines were developed under the coordination of the German interdisciplinary association for pain management DIVS and two patient support groups. The history of a typical symptom complex and the exclusion of relevant somatic causes for the pain are epecially relevant for the diagnosis of fibromyalgia syndrome. Besides the exclusion of relevant orthopaedic causes for the pain, psycho-social aspects should always be evaluated. According to the modified ACR criteria 2010, chronic widespread pain and accompanying sleep disturbances and a physical as well as mental state of exhaustion lead to the diagnosis of fibromyalgia syndrome. It is not mandatory to check tender points (ACR 1990 criteria). A graduated treatment approach depending on the severity level of the fibromyalgia syndrome in the individual patient is recommended. Active treatment options (aerobic training, meditative movement therapies, strength training) should be preferred to any drug therapy in the long-term treatment of fibromyalgia. If indicated, amitryptiline or duloxetine may be used to treat accompanying depressive or generalised anxiety disorder. Muscle relaxant medication, non-steroidal anti-inflammatory drugs and strong opioids should be avoided. The multimodal pain therapy considering all psycho-social aspects is a promising treatment option for fibromyalgia syndrome of moderate to high severity.

Authors+Show Affiliations

Department Orthopädie, Unfallchirurgie und Paraplegiologie, Universitätsklinik Heidelberg.Klinikum Saarbrücken, Funktionsbereich Psychosomatik.Department Orthopädie, Unfallchirurgie und Paraplegiologie, Universitätsklinik Heidelberg.

Pub Type(s)

English Abstract
Journal Article

Language

ger

PubMed ID

24347415

Citation

Dreher, T, et al. "[Fibromyalgia Syndrome - Updated S3 Guidelines]." Zeitschrift Fur Orthopadie Und Unfallchirurgie, vol. 151, no. 6, 2013, pp. 603-9.
Dreher T, Häuser W, Schiltenwolf M. [Fibromyalgia syndrome - updated s3 guidelines]. Z Orthop Unfall. 2013;151(6):603-9.
Dreher, T., Häuser, W., & Schiltenwolf, M. (2013). [Fibromyalgia syndrome - updated s3 guidelines]. Zeitschrift Fur Orthopadie Und Unfallchirurgie, 151(6), 603-9. https://doi.org/10.1055/s-0033-1350985
Dreher T, Häuser W, Schiltenwolf M. [Fibromyalgia Syndrome - Updated S3 Guidelines]. Z Orthop Unfall. 2013;151(6):603-9. PubMed PMID: 24347415.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Fibromyalgia syndrome - updated s3 guidelines]. AU - Dreher,T, AU - Häuser,W, AU - Schiltenwolf,M, Y1 - 2013/12/17/ PY - 2013/12/19/entrez PY - 2013/12/19/pubmed PY - 2014/8/21/medline SP - 603 EP - 9 JF - Zeitschrift fur Orthopadie und Unfallchirurgie JO - Z Orthop Unfall VL - 151 IS - 6 N2 - Patients with chronic widespread pain often present with musculo-skeletal pain and therefore often initially contact an orthopaedist. For these patients fibromyalgia syndrome is an important differential diagnosis. Recommendations for the diagnosis of and therapy for fibromyalgia syndrome based on the recent German S3 guidelines for fibromyalgia syndrome (AWMF registration number 041/004) are outlined in this paper. These guidelines were developed under the coordination of the German interdisciplinary association for pain management DIVS and two patient support groups. The history of a typical symptom complex and the exclusion of relevant somatic causes for the pain are epecially relevant for the diagnosis of fibromyalgia syndrome. Besides the exclusion of relevant orthopaedic causes for the pain, psycho-social aspects should always be evaluated. According to the modified ACR criteria 2010, chronic widespread pain and accompanying sleep disturbances and a physical as well as mental state of exhaustion lead to the diagnosis of fibromyalgia syndrome. It is not mandatory to check tender points (ACR 1990 criteria). A graduated treatment approach depending on the severity level of the fibromyalgia syndrome in the individual patient is recommended. Active treatment options (aerobic training, meditative movement therapies, strength training) should be preferred to any drug therapy in the long-term treatment of fibromyalgia. If indicated, amitryptiline or duloxetine may be used to treat accompanying depressive or generalised anxiety disorder. Muscle relaxant medication, non-steroidal anti-inflammatory drugs and strong opioids should be avoided. The multimodal pain therapy considering all psycho-social aspects is a promising treatment option for fibromyalgia syndrome of moderate to high severity. SN - 1864-6743 UR - https://www.unboundmedicine.com/medline/citation/24347415/[Fibromyalgia_syndrome___updated_s3_guidelines]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0033-1350985 DB - PRIME DP - Unbound Medicine ER -