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Feature Article

Fibromyalgia. Diagnosis and management in general practice

KATHRYN CONNELLY, Emma Guymer, GEOFFREY LITTLEJOHN

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© ANTONIOGULLIEM/ISTOCKPHOTO.COM model used for illustrative purposes only
© ANTONIOGULLIEM/ISTOCKPHOTO.COM model used for illustrative purposes only

Abstract

Fibromyalgia syndrome is a prevalent and high-impact condition, characterised by a phenotype of widespread pain, fatigue, sleep disturbance and cognitive problems. A safe and accurate diagnostic approach, with exclusion of clinically important mimics, and an individualised multimodal framework for management are essential to optimising the care and outcomes of patients in the primary care setting.

Key Points

  • Fibromyalgia is commonly encountered in general practice and affects between 2 and 8% of the population worldwide.
  • Abnormal processing of sensory information by the central nervous system results in symptoms including widespread pain, fatigue, sleep disturbance and cognitive problems.
  • Diagnosis is based on the identification of typical clinical features and rational investigation for mimicking disorders and comorbid disease as guided by individual clinical assessment.
  • Education, exercise and psychological strategies are the cornerstones of management, with drugs targeting pain modulatory mechanisms being useful adjuncts.
  • Primary care is an ideal setting to initiate and co-ordinate a multimodal and tailored management strategy for patients with fibromyalgia, review progress and provide ongoing support.

Figures

© ANTONIOGULLIEM/ISTOCKPHOTO.COM model used for illustrative purposes only
© ANTONIOGULLIEM/ISTOCKPHOTO.COM model used for illustrative purposes only