Fibromyalgia
Abstract
Fibromyalgia is a chronic pain condition present in 2-4% of the population. Fibromyalgia consists of widespread pain with similarities to neuropathic pain in clinical findings, pathophysiology, and neuropharmacology. Pain is the predominant symptom and allodynia and hyperalgesia are common signs. Extreme fatigue, impaired cognition and nonrestorative sleep difficulties coexist in addition to other somatic symptoms. Research including neuroimaging investigations shows abnormalities in neurotransmitters and an abnormal response to pain. Altered pain processing peripherally and centrally contribute to central sensitization and a dampened effect of the diffuse noxious inhibitory control (DNIC). Successful management incorporates education of the patient in self-management skills, cognitive behavioral therapy (CBT), exercise, and drug therapy. Tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors (SNRIs) (duloxetine and milnacipran), α2-δ ligands (gabapentin and pregabalin) are effective in reducing pain by≥30%. Some success has been shown with dopamine agonists (pramipexole), tramadol, other opioids and cannabinoids (nabilone). Further evidence-based trials using complementary treatments are needed. Fibromyalgia is complex and requires a multidisciplinary approach to treatment. Patient self-management is key.
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Flagged first, then by citations
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- Authors
- Sumpton, J. E., & Moulin, D. E.
- Affiliations
- London Health Sciences Centre (CA)
- Western University (CA)
- Corresponding author
- Janice E. Sumpton
- ORCID
- Dwight E. Moulin
- Venue
- Handbook of Clinical Neurology
- Publisher
- Elsevier
- Published
- 2014
- Volume
- 119
- Pages
- 513-527
- ISSN
- 0072-9752 (ISSN-L)
- OpenAlex
- W109879893
- Semantic Scholar
- 642ee0f93566f8f0f3e438d8a08003d8409b73a8
- Cited by
- 86
- References
- 124
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 8 · 2023: 5 · 2022: 14 · 2021: 16 · 2020: 7 · 2019: 13 · 2018: 3 · 2017: 3 · 2016: 4 · 2015: 4 · 2014: 1
- FWCI
- 13.52
- Type
- book chapter
- Language
- en
- Open access
- closed
- Locations
- Handbook of clinical neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- fibromyalgia, chronic widespread pain, central sensitization, diffuse noxious inhibitory control, allodynia, hyperalgesia, fatigue, sleep disorders, cognitive impairment, neurotransmitter abnormalities, tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, gabapentin, pregabalin, dopamine agonists, tramadol, opioids, cannabinoids, nabilone, cognitive behavioral therapy, physical activity, patient self-management, multidisciplinary treatment
- MeSH terms
- Fibromyalgia, Humans, History, 20th Century, History, 21st Century
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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