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Fibromyalgia: a clinical review.

Abstract

IMPORTANCE

Fibromyalgia is present in as much as 2% to 8% of the population, is characterized by widespread pain, and is often accompanied by fatigue, memory problems, and sleep disturbances.

OBJECTIVE

To review the epidemiology, pathophysiology, diagnosis, and treatment of fibromyalgia.

EVIDENCE REVIEW

The medical literature on fibromyalgia was reviewed from 1955 to March 2014 via MEDLINE and the Cochrane Central Registry of Controlled Trials, with an emphasis on meta-analyses and contemporary evidence-based treatment guidelines. Treatment recommendations are based on the most recent evidence-based guidelines from the Canadian Pain Society and graded from 1 to 5 based on the level of available evidence.

FINDINGS

Numerous treatments are available for managing fibromyalgia that are supported by high-quality evidence. These include nonpharmacological therapies (education, exercise, cognitive behavioral therapy) and pharmacological therapies (tricyclics, serotonin norepinephrine reuptake inhibitors, and gabapentinoids).

CONCLUSIONS AND RELEVANCE

Fibromyalgia and other "centralized" pain states are much better understood now than ever before. Fibromyalgia may be considered as a discrete diagnosis or as a constellation of symptoms characterized by central nervous system pain amplification with concomitant fatigue, memory problems, and sleep and mood disturbances. Effective treatment for fibromyalgia is now possible.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Professor of Anesthesiology, Medicine (Rheumatology), and Psychiatry and Director, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor.

    Source

    JAMA 311:15 2014 Apr 16 pg 1547-55

    MeSH

    Evidence-Based Medicine
    Fibromyalgia
    Humans
    Practice Guidelines as Topic

    Pub Type(s)

    Clinical Conference
    Journal Article
    Review

    Language

    eng

    PubMed ID

    24737367

    Citation

    Clauw, Daniel J.. "Fibromyalgia: a Clinical Review." JAMA, vol. 311, no. 15, 2014, pp. 1547-55.
    Clauw DJ. Fibromyalgia: a clinical review. JAMA. 2014;311(15):1547-55.
    Clauw, D. J. (2014). Fibromyalgia: a clinical review. JAMA, 311(15), pp. 1547-55. doi:10.1001/jama.2014.3266.
    Clauw DJ. Fibromyalgia: a Clinical Review. JAMA. 2014 Apr 16;311(15):1547-55. PubMed PMID: 24737367.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Fibromyalgia: a clinical review. A1 - Clauw,Daniel J, PY - 2014/4/17/entrez PY - 2014/4/17/pubmed PY - 2014/4/29/medline SP - 1547 EP - 55 JF - JAMA JO - JAMA VL - 311 IS - 15 N2 - IMPORTANCE: Fibromyalgia is present in as much as 2% to 8% of the population, is characterized by widespread pain, and is often accompanied by fatigue, memory problems, and sleep disturbances. OBJECTIVE: To review the epidemiology, pathophysiology, diagnosis, and treatment of fibromyalgia. EVIDENCE REVIEW: The medical literature on fibromyalgia was reviewed from 1955 to March 2014 via MEDLINE and the Cochrane Central Registry of Controlled Trials, with an emphasis on meta-analyses and contemporary evidence-based treatment guidelines. Treatment recommendations are based on the most recent evidence-based guidelines from the Canadian Pain Society and graded from 1 to 5 based on the level of available evidence. FINDINGS: Numerous treatments are available for managing fibromyalgia that are supported by high-quality evidence. These include nonpharmacological therapies (education, exercise, cognitive behavioral therapy) and pharmacological therapies (tricyclics, serotonin norepinephrine reuptake inhibitors, and gabapentinoids). CONCLUSIONS AND RELEVANCE: Fibromyalgia and other "centralized" pain states are much better understood now than ever before. Fibromyalgia may be considered as a discrete diagnosis or as a constellation of symptoms characterized by central nervous system pain amplification with concomitant fatigue, memory problems, and sleep and mood disturbances. Effective treatment for fibromyalgia is now possible. SN - 1538-3598 UR - https://www.unboundmedicine.com/medline/citation/24737367/full_citation L2 - https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2014.3266 DB - PRIME DP - Unbound Medicine ER -