Fibromyalgia: Changes in Diagnosis, Treatment
the MPR take:
Since the release of the American College of Rheumatology's criteria for the diagnosis of fibromyalgia in 1990, much more is known about its symptoms, comorbidity with other chronic conditions, and genetic factors. A literature review in JAMA has noted that newer diagnostic criteria are based on patient-reported symptoms, rather than the tender-point exam. It is common for patients with fibromyalgia to also have a lifelong history of chronic pain and other conditions such as osteoarthritis, rheumatoid arthritis, and lupus. Individuals suffering from fibromyalgia are also more like to have psychiatric disorders that include depression, anxiety, obsessive-compulsive disorder, and post-traumatic stress disorder. The article states that based on the existing research, the best treatment is an integration of pharmacological and nonpharmacological treatments that engage the patient as an active participant in the therapy. The article also points out that opioids, while often used to treat peripheral pain, should be discouraged for patients with fibromylagia. In fact, opioids may actually worsen fibromyalgia-related hyperalgesia.
READ FULL ARTICLE From jama.jamanetwork.com