Learn About Fibromyalgia

Fibromyalgia syndrome affects the muscles and soft tissue. 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.
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Management of fibromyalgia begins with a detailed history and a thorough physical and laboratory examination (see Presentation and Workup ). Making a correct diagnosis is crucial, and patients need to know that a name exists for the mysterious symptoms that they are experiencing.
If a patient has joint symptoms, an internist could also check rheumatoid factor and anti-cyclic citrullinated peptide antibody, and if a patient reports weakness (which is not particularly characteristic of fibromyalgia), internists could also check creatine phosphokinase, she said.

When a patient with any chronic pain state develops evidence of centralisation of pain, it is likely that treatments that work well for acute pain or pain primarily due to nociceptive input (NSAIDs, opioids, anti-inflammatories, immunosuppressives, injections, surgical procedures) will be less effective.
Although the results of their analysis indicated that depression and catastrophizing show consistent associations with a number of parameters associated with pain and treatment outcomes, it is also reported that these sequelae may be present in any number of conditions, and not only fibromyalgia.
On the other hand, if you have other noticeable symptoms which are not on the list - for example joint swelling, or fever, or weight loss - those do not support a diagnosis of fibromyalgia, and your doctor is likely to look for other causes of your symptoms.

But the PACE trial has been tainted by scandal and harshly criticized as uninterpretable.” 59 60 Unfortunately, there are good reasons to believe that PACE got it disastrously wrong, and exercise actually hurts ME patients 61 — none of which would have anything to do with fibromyalgia but for the constant clumsy conflation of the two conditions.
The exact cause of fibromyalgia is unknown, but it's thought to be related to abnormal levels of certain chemicals in the brain and changes in the way the central nervous system (the brain, spinal cord and nerves) processes pain messages carried around the body.

The diagnosis of fibromyalgia is especially suspected in people who hurt all over” or always feel as if they have the flu.” A diagnosis for fibromyalgia is ultimately made by examining the patient for specific tender points on the body, and noting whether the patient has fatigue, non-restorative sleep, difficulty concentrating, and the presence of some of the coexisting and overlapping symptoms or disorders listed above.
An 2012 Institute of Medicine (IOM) report that highlighted the inadequacies of chronic pain treatment and research and a strategic document produced in 2015 by an association of chronic pain groups will hopefully increase the NIH's commitment in this area.
The Canadian guidelines also do not require a tender point exam for diagnosis, instead recommending a clinical evaluation and physical exam to exclude other conditions presenting with body pain, similar to the American College of Rheumatology guidelines.