Why is fibromyalgia controversy

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I want to get healthier. Primary fibromyalgia fibrositis : clinical study of 50 patients with matched normal controls. Semin Arthritis Rheum. Clinical characteristics of fibrositis. The London Fibromyalgia Epidemiology Study: comparing the demographic and clinical characteristics in random community cases of fibromyalgia versus controls. J Rheumatol. Key practice points in the management of fibromyalgia.

Treatment of fibromyalgia with antidepressants: a meta-analysis. J Gen Intern Med. Treatment of fibromyalgia with cyclobenzaprine: a meta-analysis. Duloxetine for the treatment of fibromyalgia in women: pooled results from two randomized, placebo-controlled clinical trials. J Womens Health. Lessons learned combining N-of-1 trials to assess fibromyalgia therapies. Anti-depressants and centrally active agents for fibromyalgia syndrome. Protocol Cochrane Database Syst Rev.

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Contact afpserv aafp. Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev. Clauw DJ. Fibromyalgia: a clinical review.

Pain Res Manag. Combination of pregabalin with duloxetine for fibromyalgia: a randomized controlled trial. Three-quarters of persons in the US population reporting a clinical diagnosis of fibromyalgia do not satisfy fibromyalgia criteria: the National Health Interview Survey. PLoS One. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity.

Arthritis Care Res Hoboken. Report of the Multicenter Criteria Committee. Arthritis Rheum. Also from ACP, read new content every week from the most highly cited internal medicine journal.

Visit Annals. Physicians can't cure chronic pain from fibromyalgia outright, so patients should have reasonable expectations. Photo by iStock These 2 groups do mostly agree on management, however: Opioids don't work, the medications that appear to be effective are limited in their therapeutic ability, and nonpharmacological treatment approaches particularly exercise seem to be paramount in decreasing patients' pain and increasing function.

Treatment The types of treatments that work for peripheral or nociceptive pain, such as nonsteroidal anti-inflammatory drugs, opioids, injections, and surgery, won't work for the centralized pain that occurs in fibromyalgia, Dr. Management One of the biggest challenges in managing fibromyalgia, Dr. Climate Change. Conference Coverage. She had developed debilitating fatigue and horrible muscle pain and tenderness about a month after getting over a mild case of the flu.

Kissel recalls. People are talking about it all over the place. She was still working. But she had all the typical symptoms of fibromyalgia. That was a formative experience in my thinking about the condition. Today, more and more neurologists are coming around to the idea that fibromyalgia is a real disorder, and one that should be managed, or at least co-managed, by neurologists who care for chronic pain—not only the rheumatologists who originally identified the condition some years ago.

Fibromyalgia has long presented a puzzle for doctors. It's considered a syndrome—a collection of related symptoms and problems without an identifiable cause—rather than a disease. Those related symptoms include:. To be diagnosed with fibromyalgia, a person must have had widespread pain in all four quadrants of the body for at least three months, and tenderness or pain when pressure is applied in at least 11 of 18 identified "tender points.

Fibromyalgia was originally thought to be a rheumatologic condition because—like diseases such as rheumatoid arthritis—it is characterized by musculoskeletal pain. But research has since shown that there are no abnormalities in the musculoskeletal system in people with fibromyalgia. Instead, the problem appears to lie in the pain processing pathways of our central nervous system—the bailiwick of neurologists.

Today, both rheumatologists and neurologists treat fibromyalgia. The National Fibromyalgia Association estimates that between three percent and six percent of the population has fibromyalgia—mostly women, but some men and children as well. However, with a flimsier body of research than many other chronic conditions and no blood test to diagnose the disorder, controversy has swirled around fibromyalgia for years. It's also easily confused with other conditions, such as rheumatoid arthritis and lupus in fact, some patients have both.

Lynne Matallana, the founder and president of the National Fibromyalgia Association, originally saw a rheumatologist for her fibromyalgia. Recently she has also been seeing a neurologist to help with the overlapping conditions, such as migraines and restless leg syndrome, that also cause her distress.