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Fibromyalgia syndrome: Basic knowledge, diagnosis and treatment.
Med Monatsschr Pharm. 2016 Dec; 39(12):504-11.MM

Abstract

Fibromyalgia syndrome (FMS) is characterized by chronic widespread pain, unrefreshing sleep and mental/physical fatigue. Most patients report additional somatic and psychological symptoms. Fibromyalgia is a heterogeneous condition. The definite aetiology of this syndrome remains unknown. A model of interacting biological and psychosocial variables in the predisposition, triggering, and development of the chronicity of fibromyalgia symptoms has been suggested. Depression, genetics, obesity combined with physical inactivity, physical and sexual abuse in childhood, sleep problems, and smoking predict future development of fibromyalgia. Psychosocial stress (working place and family conflicts) and physical stress (infections, surgery, accidents) might trigger the onset of chronic widespread pain and fatigue. Mental disorders have a negative impact on the clinical outcome. Several factors are associated with the pathophysiology such as alteration of sensory processing in the brain, reduced reactivity of the hypothalamus-pituitary-adrenal axis to stress, increased pro-inflammatory and reduced anti-inflammatory cytokine profiles, disturbances in neurotransmitters such as dopamine and serotonin, and small fiber pathology. Prolonged exposure to stress, as outlined above, may contribute to these functional changes in predisposed individuals. The prevalence in the general German population is about 2 %. The clinical diagnosis is established by the history of the key symptoms and the exclusion of somatic diseases sufficiently explaining chronic widespread pain. For management, the German evidence and consensus based guideline recommends a stepwise approach according to the severity of FMS. All patients should receive adequate education about the disorder and its management. Non-pharmacological therapies such as low intensity aerobic exercise and meditative movement therapies such as Qi-Gong and Yoga are highly recommended for long-term self-management. Drug therapy is not mandatory. Recommended drugs are the antidepressants amitriptyline and duloxetine and the anticonvulsant pregabalin which act as pain modulators.

Authors

No affiliation info available

Pub Type(s)

Journal Article

Language

ger

PubMed ID

29979510

Citation

Häuser, Winfried. "Fibromyalgia Syndrome: Basic Knowledge, Diagnosis and Treatment." Medizinische Monatsschrift Fur Pharmazeuten, vol. 39, no. 12, 2016, pp. 504-11.
Häuser W. Fibromyalgia syndrome: Basic knowledge, diagnosis and treatment. Med Monatsschr Pharm. 2016;39(12):504-11.
Häuser, W. (2016). Fibromyalgia syndrome: Basic knowledge, diagnosis and treatment. Medizinische Monatsschrift Fur Pharmazeuten, 39(12), 504-11.
Häuser W. Fibromyalgia Syndrome: Basic Knowledge, Diagnosis and Treatment. Med Monatsschr Pharm. 2016;39(12):504-11. PubMed PMID: 29979510.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fibromyalgia syndrome: Basic knowledge, diagnosis and treatment. A1 - Häuser,Winfried, PY - 2018/7/7/entrez PY - 2016/12/1/pubmed PY - 2018/9/7/medline SP - 504 EP - 11 JF - Medizinische Monatsschrift fur Pharmazeuten JO - Med Monatsschr Pharm VL - 39 IS - 12 N2 - Fibromyalgia syndrome (FMS) is characterized by chronic widespread pain, unrefreshing sleep and mental/physical fatigue. Most patients report additional somatic and psychological symptoms. Fibromyalgia is a heterogeneous condition. The definite aetiology of this syndrome remains unknown. A model of interacting biological and psychosocial variables in the predisposition, triggering, and development of the chronicity of fibromyalgia symptoms has been suggested. Depression, genetics, obesity combined with physical inactivity, physical and sexual abuse in childhood, sleep problems, and smoking predict future development of fibromyalgia. Psychosocial stress (working place and family conflicts) and physical stress (infections, surgery, accidents) might trigger the onset of chronic widespread pain and fatigue. Mental disorders have a negative impact on the clinical outcome. Several factors are associated with the pathophysiology such as alteration of sensory processing in the brain, reduced reactivity of the hypothalamus-pituitary-adrenal axis to stress, increased pro-inflammatory and reduced anti-inflammatory cytokine profiles, disturbances in neurotransmitters such as dopamine and serotonin, and small fiber pathology. Prolonged exposure to stress, as outlined above, may contribute to these functional changes in predisposed individuals. The prevalence in the general German population is about 2 %. The clinical diagnosis is established by the history of the key symptoms and the exclusion of somatic diseases sufficiently explaining chronic widespread pain. For management, the German evidence and consensus based guideline recommends a stepwise approach according to the severity of FMS. All patients should receive adequate education about the disorder and its management. Non-pharmacological therapies such as low intensity aerobic exercise and meditative movement therapies such as Qi-Gong and Yoga are highly recommended for long-term self-management. Drug therapy is not mandatory. Recommended drugs are the antidepressants amitriptyline and duloxetine and the anticonvulsant pregabalin which act as pain modulators. SN - 0342-9601 UR - https://www.unboundmedicine.com/medline/citation/29979510/Fibromyalgia_syndrome:_Basic_knowledge_diagnosis_and_treatment_ DB - PRIME DP - Unbound Medicine ER -