Evidence-Based Treatment for Fibromyalgia Syndrome in Adults
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Fibromyalgia syndrome (FMS) is a painful disorder affecting 1 to 5 percent of the United States population, mostly women (Weir et al., 2006). FMS decreases physical and cognitive functionality. The American College of Rheumatology (ACR) FMS classification criteria published in 1990 have been used to identify patients with FMS. The FMS classification criteria include chronic widespread pain present for more than 3 months and specified tender point areas. At least 11 of 18 total tender points must be present upon digital palpation with applied pressure of 4 kg (Dunphy et al., 2011). Wolfe et al., (2010) proposed a diagnostic criteria that does not depend on counting tender points and which measures the symptom severity score (SSS) in the disorder. This consists of measuring severity of fatigue, sleep disruption, cognitive symptoms; and the widespread pain index (WPI), which measures pain lasting three months or more in 11 out of 19 areas of the body. Etiology of the syndrome is not clear; multiple possible causes of the disorder have been proposed such as physical and psychosocial stressors, abnormal functioning of the neuroendocrine and autonomic systems, and a genetic component. Treatment for FMS remains controversial and mainly focused on the primary complaint, generalized pain; however, many other symptoms remain untreated or are exacerbated, sustaining a disturbed cognitive and physical functionality that results in a decreased quality of life. The purpose of this manuscript is to review the pathophysiology of the syndrome, diagnostic criteria, and pharmacological and non-pharmacological treatments for FMS symptoms that greatly impact patients’ lives.