Fibromyalgia
EBM Guidelines
Dec 14, 2021 • Latest change Apr 18, 2023
Table of contents
Extract
- Fibromyalgia is a combination of individually varying symptoms and findings of various causes; its severity and symptoms vary in different individuals and periods.
- Fibromyalgia should be suspected if the patient suffers from long-standing, widespread pain (aches, pains, tenderness to touch) stemming from the musculoskeletal system and not sufficiently explained by injury, damage or inflammation.
- Practical diagnostic criteria based on a patient questionnaire have been suggested for fibromyalgia (see Pain symptom questionnaire Pain symptom questionnaire1).
- Many unnecessary examinations and treatments can be avoided by sufficiently early diagnosis.
- Patient guidance and self care methods form the mainstay of treatment. Regular physical exercise and increasing muscle strength and endurance fitness reduce the symptoms of fibromyalgia .
- Pharmacotherapy is mainly symptomatic and used to support self care.
Linked evidence summaries
- Amitriptyline appears to relieve pain effectively in about 1 in 4 (25%) more people with fibromyalgia than does placebo. About 1 in 3 (31%) more people than with placebo report having one or more adverse events.B
- Gabapentin at daily dose 2400 mg may be effective in selected patients with fibromyalgia.C
Search terms
Amitriptyline, Fibromyalgia, Internal medicine, M79.0, M79.7, Pain, Pain, Physical medicine, Psychiatry, Rheumatology, trigger point