Feature Article

Fibromyalgia: mechanisms and management

Geoffrey O Littlejohn, Emma Guymer



Fibromyalgia is chronic pain syndrome characterised by changes in biochemical functions within the pain system. Treatment includes education about the condition, exercises and psychological strategies, as well as pain-control medication.

Key Points

  • The key clinical elements of fibromyalgia are the presence of widespread chronic pain and widespread abnormal tenderness to gentle pressure.
  • Fibromyalgia is due to abnormal sensitivity within the pain-related nervous system.
  • Six or more abnormally tender sites, combined with widespread pain, will allow a diagnosis of fibromyalgia to be made.
  • Fibromyalgia often co-exists with other conditions and it may have similar presenting symptoms to many other disorders.
  • The basic management platform of education, exercise and psychological strategies must be initiated in all patients with fibromyalgia.
  • Analgesics, antidepressants and antiepileptics have been shown to be effective for the treatment of fibromyalgia.