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Fibromyalgia: a clinical review

updated

Tags: fibromyalgia, good news, chronic pain, pain problems

One article on PainSci cites Clauw 2014: The 3 Basic Types of Pain

PainSci notes on Clauw 2014:

An unusually optimistic narrative review of the scientific literature on fibromyalgia, concluding that it is “much better understood now than ever before” and that several treatments are “supported by high-quality evidence.”

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

IMPORTANCE: Fibromyalgia is present in as much as 2% to 8% of the population, is characterized by widespread pain, and is often accompanied by fatigue, memory problems, and sleep disturbances.

OBJECTIVE: To review the epidemiology, pathophysiology, diagnosis, and treatment of fibromyalgia.

EVIDENCE REVIEW: The medical literature on fibromyalgia was reviewed from 1955 to March 2014 via MEDLINE and the Cochrane Central Registry of Controlled Trials, with an emphasis on meta-analyses and contemporary evidence-based treatment guidelines. Treatment recommendations are based on the most recent evidence-based guidelines from the Canadian Pain Society and graded from 1 to 5 based on the level of available evidence.

FINDINGS: Numerous treatments are available for managing fibromyalgia that are supported by high-quality evidence. These include nonpharmacological therapies (education, exercise, cognitive behavioral therapy) and pharmacological therapies (tricyclics, serotonin norepinephrine reuptake inhibitors, and gabapentinoids).

CONCLUSIONS AND RELEVANCE: Fibromyalgia and other "centralized" pain states are much better understood now than ever before. Fibromyalgia may be considered as a discrete diagnosis or as a constellation of symptoms characterized by central nervous system pain amplification with concomitant fatigue, memory problems, and sleep and mood disturbances. Effective treatment for fibromyalgia is now possible.

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