Beyond pain in fibromyalgia: Insights into the symptom of fatigue

Vincent, Ann; Benzo, Roberto P; Whipple, Mary O; McAllister, Samantha J; Erwin, Patricia J; Saligan, Leorey N

doi:10.1186/ar4395

Cited by 133Fibromyalgia and Chronic Fatigue Syndrome ResearchMusculoskeletal pain and rehabilitationGastrointestinal motility and disorders

Beyond pain in fibromyalgia: Insights into the symptom of fatigue

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Vincent, Ann, Benzo, Roberto P, Whipple, Mary O, McAllister, Samantha J, Erwin, Patricia J, Saligan, Leorey N·2013·Arthritis Research & Therapy

DOI 10.1186/ar4395PMC PMC3978642

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Abstract

Fatigue is a disabling, multifaceted symptom that is highly prevalent and stubbornly persistent. Although fatigue is a frequent complaint among patients with fibromyalgia, it has not received the same attention as pain. Reasons for this include lack of standardized nomenclature to communicate about fatigue, lack of evidence-based guidelines for fatigue assessment, and a deficiency in effective treatment strategies. Fatigue does not occur in isolation; rather, it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain, unrefreshing sleep, anxiety, depression, cognitive difficulties, and so on. Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physiological mechanisms. Therefore, fatigue assessment in clinical and research settings must consider this multi-dimensionality. While no clinical trial to date has specifically targeted fatigue, randomized controlled trials, systematic reviews, and meta-analyses indicate that treatment modalities studied in the context of other fibromyalgia symptoms could also improve fatigue. The Outcome Measures in Rheumatology (OMERACT) Fibromyalgia Working Group and the Patient Reported Outcomes Measurement Information System (PROMIS) have been instrumental in propelling the study of fatigue in fibromyalgia to the forefront. The ongoing efforts by PROMIS to develop a brief fibromyalgia-specific fatigue measure for use in clinical and research settings will help define fatigue, allow for better assessment, and advance our understanding of fatigue.

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Fatigue has been shown to be highly prevalent, persistent and disabling in patients with fibromyalgia.
“this symptom has been shown to be highly prevalent, persistent and disabling in patients with fibromyalgia [25,26,27].”
From Do Cognitive Abilities Influence Physical and Mental Fatigue in Patients with Chronic Pain after Walking According to a Clinical Guideline for Physical Exercise? (2021) · cites this paper as [27]

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McLean, S. A., Williams, D. A., Stein, P. K., Harris, R. E., Lyden, A. K., Whalen, G., Park, K. M., Liberzon, I., Sen, A., Gracely, R. H., et al. (2006) · Neuropsychopharmacology · doi:10.1038/sj.npp.1301200 · Cited by 98 · see citing works
The effect of combined therapy (ultrasound and interferential current) on pain and sleep in fibromyalgia
de Almeida, T. F., Roizenblatt, S., Benedito‐Silva, A. A., & Tufik, S. B. (2003) · Pain · doi:10.1016/s0304-3959(03)00139-8 · Cited by 96 · see citing works
Amitriptyline in the treatment of fibromyalgia: a systematic review of its efficacy
Nishishinya, B., Urrútia, G., Walitt, B. T., Rodríguez, A., Bonfill, X., Alegre, C., & Darko, G. (2008) · Lara D. Veeken · doi:10.1093/rheumatology/ken317 · Cited by 96 · see citing works
Self-Reported Sleep Quality and Fatigue Correlates With Actigraphy in Midlife Women With Fibromyalgia
Landis, C. A., Frey, C. A., Lentz, M. J., Rothermel, J., Buchwald, D., & Shaver, J. L. F. (2003) · Nursing Research · doi:10.1097/00006199-200305000-00002 · Cited by 92 · see citing works
Fibromyalgia syndrome improved using a mostly raw vegetarian diet: An observational study
Donaldson, M. S., Speight, N., & Loomis, S. (2001) · BMC Complementary and Alternative Medicine · doi:10.1186/1472-6882-1-7 · Cited by 90 · see citing works
The Comparative Economic Burden of Mild, Moderate, and Severe Fibromyalgia: Results from a Retrospective Chart Review and Cross-Sectional Survey of Working-Age U.S. Adults
Chandran, A., Schaefer, C. P., Ryan, K. J., Baik, R., McNett, M., & Zlateva, G. (2012) · Journal of Managed Care Pharmacy · doi:10.18553/jmcp.2012.18.6.415 · Cited by 88 · see citing works
Efficacy and safety of milnacipran 100 mg/day in patients with fibromyalgia: Results of a randomized, double‐blind, placebo‐controlled trial
Arnold, L. M., Gendreau, R. M., Palmer, R. H., Gendreau, J., & Wang, Y. (2010) · Arthritis & Rheumatism · doi:10.1002/art.27559 · Cited by 87 · see citing works
Hypothalamic-pituitary-gonadal axis and cortisol in young women with primary fibromyalgia: the potential roles of depression, fatigue, and sleep disturbance in the occurrence of hypocortisolism
Gür, A., Cevik, R., Sarac, A. J., Colpan, L., & Em, S. (2004) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2003.014969 · Cited by 87 · see citing works
Can Coenzyme Q 10 Improve Clinical and Molecular Parameters in Fibromyalgia?
Cordero, M. D., Alcocer‐Gómez, E., de Miguel, M., Čulić, O., Carrión, Á. M., Álvarez-Suárez, J. M., Bullón, P., Battino, M. A., Fernández-Rodríguez, A., & Sánchez-Alcázar, J. A. (2013) · Antioxidants and Redox Signaling · doi:10.1089/ars.2013.5260 · Cited by 84 · see citing works
The meaning of fatigue and tiredness as narrated by women with fibromyalgia and healthy women
Söderberg, S., Lundman, B. M., & Norberg, A. (2002) · Journal of Clinical Nursing · doi:10.1046/j.1365-2702.2002.00606.x · Cited by 83 · see citing works
Effects of Concurrent Strength and Endurance Training on Physical Fitness and Symptoms in Postmenopausal Women With Fibromyalgia: A Randomized Controlled Trial
Valkeinen, H., Alén, M., HÄKKINEN, A. H., Hannonen, P., Kukkonen-Harjula, K. T., & Häkkinen, K. (2008) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2008.01.022 · Cited by 83 · see citing works
Daily Affect Relations in Fibromyalgia Patients Reveal Positive Affective Disturbance
Finan, P. H., Zautra, A., & Davis, M. C. (2009) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31819e0a8b · Cited by 82 · see citing works
Measurement properties of the Medical Outcomes Study Sleep Scale in patients with fibromyalgia
Cappelleri, J. C., Bushmakin, A. G., McDermott, A. M., Dukes, E. M., Sadosky, A., Petrie, C. D., & Martin, S. A. (2009) · Sleep Medicine · doi:10.1016/j.sleep.2008.09.004 · Cited by 81 · see citing works
A European Multicenter Randomized Double-blind Placebo-controlled Monotherapy Clinical Trial of Milnacipran in Treatment of Fibromyalgia
Branco, J., Zachrisson, O., Perrot, S., & Mainguy, Y. (2010) · The Journal of Rheumatology · doi:10.3899/jrheum.090884 · Cited by 81 · see citing works
Content and Criterion Validity of the Preliminary Core Dataset for Clinical Trials in Fibromyalgia Syndrome
CHOY, E. H., ARNOLD, L. M., CLAUW, D. J., CROFFORD, L. J., GLASS, J. M., SIMON, L. S., MARTIN, S. A., STRAND, C. V., WILLIAMS, D. A., & MEASE, P. J. (2009) · The Journal of Rheumatology · doi:10.3899/jrheum.090368 · Cited by 76 · see citing works
Fatigue and patterns of pain in fibromyalgia: Correlations with anxiety, depression and co‐morbidity in a female county sample
Kurtze, N., & Svebak, S. (2001) · British Journal of Medical Psychology · doi:10.1348/000711201161163 · Cited by 76 · see citing works
Effect of gamma-hydroxybutyrate on pain, fatigue, and the alpha sleep anomaly in patients with fibromyalgia. Preliminary report.
Mb, S., Hauck, M., Stover, R., McDannold, M. D., & Berkowitz, D. (1998) · PubMed · Cited by 75 · see citing works
A six‐month randomized controlled trial of exercise and pyridostigmine in the treatment of fibromyalgia
Jones, K. D., Burckhardt, C. S., Deodhar, A. A., Perrin, N., Hanson, G. C., & Bennett, R. M. (2008) · Arthritis & Rheumatism · doi:10.1002/art.23203 · Cited by 72 · see citing works
Fatigue and widespread pain in systemic lupus erythematosus and Sjögren's syndrome: symptoms of the inflammatory disease or associated fibromyalgia?
Iannuccelli, C., Spinelli, F. R., Guzzo, M. P., Priori, R., Conti, F., Ceccarelli, F., Pietropaolo, M., Olivieri, M., Minniti, A., Alessandri, C., et al. (2012) · PubMed · Cited by 71 · see citing works
The Experience of Living With Fibromyalgia: Confronting an Invisible Disability
Sturge-Jacobs, M. (2002) · Research and theory for nursing practice · doi:10.1891/rtnp.16.1.19.52994 · Cited by 71 · see citing works
Effectiveness of high-frequency transcutaneous electrical nerve stimulation at tender points as adjuvant therapy for patients with fibromyalgia.
Carbonario, F., Matsutani, L. A., Yuan, S. L. K., & Marques, A. P. (2013) · PubMed · Cited by 70 · see citing works
Multidisciplinary treatment of fibromyalgia: Does cognitive behavior therapy increase the response to treatment?
Lera, S., Gelman, S. M., López, M. J., Abenoza, M., Zorrilla, J. G., Castro-Fornieles, J., & Salamero, M. (2009) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2009.01.012 · Cited by 68 · see citing works
Fatigue in fibromyalgia: a conceptual model informed by patient interviews
Humphrey, L., Arbuckle, R., Mease, P., Williams, D. A., Samsoe, B. D., & Gilbert, C. (2010) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-11-216 · Cited by 68 · see citing works
Sequential Analyses of Daily Symptoms in Women With Fibromyalgia Syndrome
Okifuji, A., Bradshaw, D. H., Donaldson, G. W., & Turk, D. C. (2010) · Journal of Pain · doi:10.1016/j.jpain.2010.05.003 · Cited by 67 · see citing works
Toward Development of a Fibromyalgia Responder Index and Disease Activity Score: OMERACT Module Update
Mease, P. J., Clauw, D. J., Christensen, R., Crofford, L. J., Gendreau, R. M., Martin, S. A., Simon, L. S., Strand, V., Williams, D. A., Arnold, L. M., et al. (2011) · The Journal of Rheumatology · doi:10.3899/jrheum.110277 · Cited by 66 · see citing works
The role of anxiety and depression in fatigue and patterns of pain among subgroups of fibromyalgia patients
Kurtze, N., Gundersen, K. T., & Svebak, S. (1998) · British Journal of Medical Psychology · doi:10.1111/j.2044-8341.1998.tb01379.x · Cited by 66 · see citing works
Effectiveness of a Psychoeducational Treatment Program Implemented in General Practice for Fibromyalgia Patients: A Randomized Controlled Trial
Luciano, J. V., Martínez, N., Peñarrubia-María, M. T., Fernández-Vergel, R., García-Campayo, J., Verduras, C., Blanco, M. E., Jiménez, M., Ruiz, J. M., del Hoyo, Y. L., et al. (2011) · The Clinical Journal of Pain · doi:10.1097/ajp.0b013e31820b131c · Cited by 65 · see citing works
Komplementäre und alternative Verfahren beim Fibromyalgiesyndrom
Langhorst, J., Häuser, W., Bernardy, K., Lucius, H., Settan, M., Winkelmann, A., & Musial, F. (2012) · Der Schmerz · doi:10.1007/s00482-012-1178-9 · Cited by 63 · see citing works
Double-blind, Placebo-controlled Cross-over Study of Intravenous S-Adenosyl-L-Methionine in Patients with Fibromyalgia
Volkmann, H. P., Nørregaard, J., Jacobsen, S., Danneskiold‐Samsøe, B., Knoke, G., & Nehrdich, D. (1997) · Scandinavian Journal of Rheumatology · doi:10.3109/03009749709065682 · Cited by 63 · see citing works
Double-blind, multicenter trial comparing acetyl l-carnitine with placebo in the treatment of fibromyalgia patients.
Rossini, M., Munno, O. D., Valentini, G., Bianchi, G., Biasi, G., Cacace, E., Malesci, D., MONTAGNA, G. L., Viapiana, O., & Adami, S. (2007) · PubMed · Cited by 60 · see citing works
Open Trial of Mirtazapine in Patients with Fibromyalgia
Samborski, W., Lezanska-Szpera, M., & Rybakowski, J. K. (2004) · Pharmacopsychiatry · doi:10.1055/s-2004-827172 · Cited by 59 · see citing works
Aspects of diurnal rhythmicity in pain, stiffness, and fatigue in patients with fibromyalgia.
Bellamy, N., Sothern, R. B., & Campbell, J. (2004) · PubMed · Cited by 52 · see citing works
A Pilot Study of External Qigong Therapy for Patients with Fibromyalgia
Chen, K. W., Hassett, A. L., Hou, F., Staller, J., & Lichtbroun, A. S. (2006) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2006.12.851 · Cited by 52 · see citing works
Impact of an occupation‐based self‐management programme on chronic disease management
Toole, L. O., Connolly, D., & Smith, S. M. (2012) · Australian Occupational Therapy Journal · doi:10.1111/1440-1630.12008 · Cited by 52 · see citing works
Relationship between body mass index, fat mass and lean mass with SF-36 quality of life scores in a group of fibromyalgia patients
Arranz, L., Canela, M. Á., & Rafecas, M. (2011) · Rheumatology International · doi:10.1007/s00296-011-2250-y · Cited by 51 · see citing works
Association of fibromyalgia with altered skeletal muscle characteristics which may contribute to postexertional fatigue in postmenopausal women
Srikuea, R., Symons, T. B., Long, D. E., Lee, J. D., Shang, Y., Chomentowski, P. J., Yu, G., Crofford, L. J., & Peterson, C. A. (2012) · Arthritis & Rheumatism · doi:10.1002/art.37763 · Cited by 51 · see citing works
The effect of graded resistance exercise on fibromyalgia symptoms and muscle bioenergetics: A pilot study
Geel, S. E., & Robergs, R. A. (2002) · Arthritis Care & Research · doi:10.1002/art1.10240 · Cited by 49 · see citing works
Prognosis of Fatigue and Functioning in Primary Care: A 1-Year Follow-up Study
Nijrolder, I., van der Windt, D., & van der Horst, H. E. (2008) · The Annals of Family Medicine · doi:10.1370/afm.908 · Cited by 49 · see citing works
Effectiveness of multidisciplinary therapy on symptomatology and quality of life in women with fibromyalgia.
Carbonell‐Baeza, A., Aparicio, V. A., Chillón, P., Femia, P., Delgado‐Fernández, M., & Ruiz, J. R. (2011) · PubMed · Cited by 47 · see citing works
Psychotherapie von Patienten mit Fibromyalgiesyndrom
Köllner, V., Häuser, W., Klimczyk, K., Kühn-Becker, H., Settan, M., Weigl, M. B., & Bernardy, K. (2012) · Der Schmerz · doi:10.1007/s00482-012-1179-8 · Cited by 47 · see citing works
A randomized controlled trial of dehydroepiandrosterone in postmenopausal women with fibromyalgia.
Finckh, A., Berner, I. C., Aubry‐Rozier, B., & So, A. K.-L. (2005) · PubMed · Cited by 45 · see citing works
Improvement in multiple dimensions of fatigue in patients with fibromyalgia treated with duloxetine: secondary analysis of a randomized, placebo-controlled trial
Arnold, L. M., Wang, F., AHL, J. S. B., Gaynor, P. J., & Wohlreich, M. M. (2011) · Arthritis Research & Therapy · doi:10.1186/ar3359 · Cited by 44 · see citing works
Psychotherapie bei Patienten mit Fibromyalgiesyndrom
Thieme, K., Häuser, W., Batra, A., Bernardy, K., Felde, E., Gesmann, M., Illhardt, A., Settan, M., Wörz, R., & Köllner, V. (2008) · Der Schmerz · doi:10.1007/s00482-008-0674-4 · Cited by 44 · see citing works
Vegetarian diet in the treatment of fibromyalgia.
Azad, K. A., Alam, M. N., Haq, S. A., Nahar, S., Chowdhury, M. A., Ali, S., & Ullah, A. K. (2000) · PubMed · Cited by 43 · see citing works
Systematic Review of Psychological Treatment in Fibromyalgia
Lami, M. J., Martínez, M. P., & Sánchez, A. I. (2013) · Current Pain and Headache Reports · doi:10.1007/s11916-013-0345-8 · Cited by 40 · see citing works
Safety and efficacy of esreboxetine in patients with fibromyalgia: A fourteen‐week, randomized, double‐blind, placebo‐controlled, multicenter clinical trial
Arnold, L. M., Hirsch, I., Sanders, P. W., Ellis, A., & Hughes, B. (2012) · Arthritis & Rheumatism · doi:10.1002/art.34390 · Cited by 40 · see citing works
An open-label study of quetiapine in the treatment of fibromyalgia
Hidalgo, J., Rico‐Villademoros, F., & Calandre, E. P. (2006) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2006.06.023 · Cited by 40 · see citing works
Fatigue in Sjogren's syndrome: relationship with fibromyalgia, clinical and biologic features.
Priori, R., Iannuccelli, C., Alessandri, C., Modesti, M., Antonazzo, B., Lollo, A. C. D., Valesini, G., & Franco, M. D. (2010) · PubMed · Cited by 39 · see citing works
Fibromyalgia treatment with intravenous tropisetron administration.
Stratz, T., Färber, L., Varga, B., Baumgartner, C., Haus, U., & Müller, W. (2001) · PubMed · Cited by 34 · see citing works
Effects of Panax Ginseng Extract in Patients with Fibromyalgia: A 12-week, Randomized, Double-blind, Placebo-controlled Trial
Braz, A. S., de Morais, L. C. S. L., Paula, A. P., Diniz, M. D. F. F. M., & de Almeida, R. N. (2013) · Brazilian Journal of Psychiatry · doi:10.1016/j.rbp.2013.01.004 · Cited by 31 · see citing works
A Randomized Placebo-Controlled Study of Noninvasive Cortical Electrostimulation in the Treatment of Fibromyalgia Patients
Hargrove, J. B., Bennett, R. M., Simons, D. G., Smith, S. J., Nagpal, S., & Deering, D. E. (2012) · Pain Medicine · doi:10.1111/j.1526-4637.2011.01292.x · Cited by 30 · see citing works
Longterm Therapeutic Response to Milnacipran Treatment for Fibromyalgia. A European 1-Year Extension Study Following a 3-Month Study
Branco, J., Cherin, P., Montagne, A., & Bouroubi, A. (2011) · The Journal of Rheumatology · doi:10.3899/jrheum.101025 · Cited by 29 · see citing works
Safety and efficacy of esreboxetine in patients with fibromyalgia: An 8-week, multicenter, randomized, double-blind, placebo-controlled study
Arnold, L. M., Chatamra, K., Hirsch, I., & Stoker, M. (2010) · Clinical Therapeutics · doi:10.1016/j.clinthera.2010.08.003 · Cited by 28 · see citing works
Long‐term follow up of a physical therapy programme for patients with fibromyalgia syndrome
Hävermark, A., & Langius‐Eklöf, A. (2006) · Scandinavian Journal of Caring Sciences · doi:10.1111/j.1471-6712.2006.00410.x · Cited by 28 · see citing works
Genetics and Gene Expression Involving Stress and Distress Pathways in Fibromyalgia with and without Comorbid Chronic Fatigue Syndrome
Light, K. C., White, A. T., Tadler, S. C., Iacob, E., & Light, A. R. (2011) · Pain Research and Treatment · doi:10.1155/2012/427869 · Cited by 26 · see citing works
Modafinil Treatment for Fatigue Associated with Fibromyalgia
Schwartz, T. L., Rayancha, S., Rashid, A., Chlebowksi, S., Chilton, M., & Morell, M. (2007) · JCR Journal of Clinical Rheumatology · doi:10.1097/01.rhu.0000255801.32408.6e · Cited by 26 · see citing works
Physical and Psychological Variables That Influence Pain in Patients With Fibromyalgia
Hughes, L. (2006) · Orthopaedic Nursing · doi:10.1097/00006416-200603000-00007 · Cited by 25 · see citing works
Assessing fibromyalgia-related fatigue: content validity and psychometric performance of the Fatigue Visual Analog Scale in adult patients with fibromyalgia.
Crawford, B., Piault, E. C., Lai, C., & Bennett, R. M. (2011) · PubMed · Cited by 23 · see citing works
Psychological control is a key modulator of fibromyalgia symptoms and comorbidities
Littlejohn, G. O., & Malin (2012) · Journal of Pain Research · doi:10.2147/jpr.s37056 · Cited by 23 · see citing works
Results of a multidisciplinary program for patients with fibromyalgia implemented in the primary care
van Wilgen, C. P., Bloten, H., & Oeseburg, B. (2007) · Disability and Rehabilitation · doi:10.1080/09638280600949860 · Cited by 23 · see citing works
Efficacy of Raloxifen in treatment of fibromyalgia in menopausal women
Sadreddini, S., Molaeefard, M., Noshad, H., Ardalan, M., & Asadi, A. (2007) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2007.10.006 · Cited by 21 · see citing works
A Successful, Long-Term Exercise Program for Women With Fibromyalgia Syndrome and Chronic Fatigue and Immune Dysfunction Syndrome
Karper, W. B., & STASIK, S. C. (2003) · Clinical Nurse Specialist · doi:10.1097/00002800-200309000-00008 · Cited by 21 · see citing works
Electroconvulsive therapy in patients with depression and fibromyalgia
Huuhka, M. J., Haanpää, M., & Leinonen, E. (2004) · European Journal of Pain · doi:10.1016/j.ejpain.2003.11.001 · Cited by 21 · see citing works
Managing fatigue in patients with chronic conditions in primary care
Connolly, D., O'Toole, L., Redmond, P., & Smith, S. M. (2013) · Family Practice · doi:10.1093/fampra/cmt005 · Cited by 20 · see citing works
Clinical characteristics of 150 consecutive fibromyalgia patients attending an Australian public hospital clinic
Guymer, E. K., Maruff, P. T., & Littlejohn, G. O. (2012) · International Journal of Rheumatic Diseases · doi:10.1111/j.1756-185x.2012.01767.x · Cited by 16 · see citing works
Gene expression profiles of fatigued fibromyalgia patients with different categories of pain and catastrophizing: A preliminary report
Lukkahatai, N., Majors, B. L., Reddy, S. Y., Walitt, B. T., & Saligan, L. N. (2013) · Nursing Outlook · doi:10.1016/j.outlook.2013.03.007 · Cited by 16 · see citing works
Self-citation
Armodafinil for Fibromyalgia Fatigue
Schwartz, T. L., Siddiqui, U. A., Raza, S., & Morell, M. (2010) · Annals of Pharmacotherapy · doi:10.1345/aph.1m736 · Cited by 16 · see citing works
Fibromyalgia and Fatigue: Central Processing, Widespread Dysfunction
Finan, P., & Zautra, A. (2010) · PM & R : the journal of injury, function, and rehabilitation · doi:10.1016/j.pmrj.2010.03.021 · Cited by 16 · see citing works
Long-term Maintenance of Response Across Multiple Fibromyalgia Symptom Domains in a Randomized Withdrawal Study of Pregabalin
Pauer, L., Atkinson, G., Murphy, T. K., Petersel, D. L., & Zeiher, B. G. (2012) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e31823dd315 · Cited by 13 · see citing works
Treatment of the Narcoleptiform Sleep Disorder in Chronic Fatigue Syndrome and Fibromyalgia with Sodium Oxybate
Spitzer, A. R., & Broadman, M. (2010) · Pain Practice · doi:10.1111/j.1533-2500.2009.00334.x · Cited by 13 · see citing works
Efficacy of the "body movement and perception" method in the treatment of fibromyalgia syndrome: an open pilot study.
Bongi, S. M., Felice, C. D., Rosso, A. D., Landi, G., Maresca, M., Ben, G. G. D., & Matucci‐Cerinic, M. (2011) · PubMed · Cited by 12 · see citing works
The Prediction of Fatigue in Fibromyalgia
Nicassio, P. M., & Schuman, C. (2005) · Journal of Musculoskeletal Pain · doi:10.1300/j094v13n01_03 · Cited by 12 · see citing works
Reduction of fibromyalgia symptoms through intravenous nutrient therapy: results of a pilot clinical trial.
Massey, P. B. (2007) · PubMed · Cited by 9 · see citing works
Temperament and Fatigue Management in Persons With Chronic Rheumatic Disease
Droegemueller, C., Brauer, D. J., & van Buskirk, D. J. (2007) · Clinical Nurse Specialist · doi:10.1097/01.nur.0000304180.59439.48 · Cited by 6 · see citing works
Clinical Domains of Fibromyalgia Syndrome: Determination through the OMERACT Process
Choy, E. (2010) · Journal of Musculoskeletal Pain · doi:10.3109/10582452.2010.502623 · Cited by 4 · see citing works

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Fibromyalgia: A Critical and Comprehensive Review
Borchers, A. T., & Gershwin, M. E. (2015) · Clinical Reviews in Allergy & Immunology · doi:10.1007/s12016-015-8509-4 · Cited by 279 · see citing works
Self-reported quality of life, anxiety and depression in individuals with Ehlers-Danlos syndrome (EDS): a questionnaire study
Berglund, B., Pettersson, C., Pigg, M., & Kristiansson, P. (2015) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-015-0549-7 · Cited by 89 · see citing works
Fibromyalgia has a larger impact on physical health than on psychological health, yet both are markedly affected: The al-Ándalus project
Segura‐Jiménez, V., Álvarez‐Gallardo, I. C., Carbonell‐Baeza, A., Aparicio, V. A., Ortega, F. B., Casimiro, A. J., & Delgado‐Fernández, M. (2014) · Seminars in Arthritis and Rheumatism · doi:10.1016/j.semarthrit.2014.09.010 · Cited by 89 · see citing works
Resistance exercise improves physical fatigue in women with fibromyalgia: a randomized controlled trial
Ericsson, A., Palstam, A., Larsson, A., Löfgren, M., Bilevičiūtė-Ljungar, I., Bjersing, J. L., Gerdle, B. U. C., Kosek, E., & Mannerkorpi, K. (2016) · Arthritis Research & Therapy · doi:10.1186/s13075-016-1073-3 · Cited by 91 · see citing works
Physical and psychological paths toward less severe fibromyalgia: A structural equation model
Pulido‐Martos, M., Luque-Reca, O., Segura‐Jiménez, V., Álvarez‐Gallardo, I. C., Soriano‐Maldonado, A., Acosta‐Manzano, P., Gavilán‐Carrera, B., McVeigh, J. G., Geenen, R., Delgado‐Fernández, M., et al. (2019) · Annals of Physical and Rehabilitation Medicine · doi:10.1016/j.rehab.2019.06.017 · Cited by 66 · see citing works
Combined exercise training reduces fatigue and modulates the cytokine profile of T-cells from multiple sclerosis patients in response to neuromediators
Alvarenga-Filho, H., Sacramento, P. M., Ferreira, T. B., Hygino, J., Abreu, J. E. C., de Carvalho, S. R. D. S., Wing, A. C., Alvarenga, R. M. P., & Bento, C. A. M. (2016) · Journal of Neuroimmunology · doi:10.1016/j.jneuroim.2016.02.014 · Cited by 68 · see citing works
Amitriptyline for the treatment of fibromyalgia: a comprehensive review
Rico‐Villademoros, F., Slim, M., & Calandre, E. P. (2015) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.2015.1091726 · Cited by 64 · see citing works
Evidence for the improvement of fatigue in fibromyalgia: A 4‐week left dorsolateral prefrontal cortex repetitive transcranial magnetic stimulation randomized‐controlled trial
Fitzgibbon, B. M., Hoy, K. E., Knox, L. A., Guymer, E. K., Littlejohn, G., Elliot, D., Wambeek, L. E., McQueen, S., Elford, K. A., Lee, S. J., et al. (2018) · European Journal of Pain · doi:10.1002/ejp.1213 · Cited by 72 · see citing works
‘Exercise to me is a scary word’: perceptions of fatigue, sleep dysfunction, and exercise in people with fibromyalgia syndrome—a focus group study
Russell, D., Álvarez‐Gallardo, I. C., Wilson, I. M., Hughes, C., Davison, G. W., Sañudo, B., & McVeigh, J. G. (2018) · Rheumatology International · doi:10.1007/s00296-018-3932-5 · Cited by 59 · see citing works
Fibromyalgia and Inflammation: Unrevealing the Connection
García‐Domínguez, M. (2025) · Cells · doi:10.3390/cells14040271 · Cited by 63 · see citing works
Neurodiversity and the Accessible University: Exploring Organizational Barriers, Access Labor and Opportunities for Change
Borsotti, V., Begel, A., & Bjørn, P. (2024) · Proceedings of the ACM on Human-Computer Interaction · doi:10.1145/3641011 · Cited by 54 · see citing works
The management of fibromyalgia from a psychosomatic perspective: an overview
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Fatigue in rheumatic diseases
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REVIEW Beyond pain in fibromyalgia: insights into the symptom of fatigue
Vincent, A., Benzo, R. P., McAllister, S. J., Erwin, P. J., & Saligan, L. N. (2014)
Self-citation
AB0949 Development of the Multidimensional Daily Diary of Fatigue Symptoms-Fibromyalgia-17 Item Instrument (DFS-Fibro-17) in Fibromyalgia Patients
Morris, S. J., Li, Y., Burbridge, C., Symonds, T. L., & Hudgens, S. A. (2015) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2015-eular.4581
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Fatigue in fibromyalgia: a mental and physical context
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AB0928 Fatigue in fibromyalgia reflects overall burden of disease
Antivalle, M., Batticciotto, A., Rigamonti, F., Ditto, M. C., Gerardi, M., Talotta, R., Mutti, A., & Sarzi‐Puttini, P. (2017) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2017-eular.6534

Authors: Vincent, A., Benzo, R. P., Whipple, M. O., McAllister, S. J., Erwin, P. J., & Saligan, L. N.
Affiliations: Mayo Clinic (US)
National Institute of Nursing Research (US)
Corresponding author: Vincent, Ann
ORCID: Benzo, Roberto P
Whipple, Mary O
Saligan, Leorey N
Venue: Arthritis Research & Therapy
Publisher: Springer Science and Business Media LLC
Published: 2013
Volume: 15
Issue: 6
Pages: 221
ISSN: 1478-6354 (ISSN-L)
DOI: 10.1186/ar4395
PMC: PMC3978642
OpenAlex: W2166151683
Semantic Scholar: b8fb41248b696377273e42d76b3a07135de684ca
Cited by: 133
References: 156
Citations by year: 2026: 12 · 2025: 14 · 2024: 21 · 2023: 13 · 2022: 14 · 2021: 9 · 2020: 14 · 2019: 6 · 2018: 6 · 2017: 5 · 2016: 9 · 2015: 8 · 2014: 2
FWCI: 0.86
Type: journal article
Language: en
Open access: gold
doi.org
Locations: Arthritis Research & Therapy (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Georgia Clinical and Translational Science Alliance
National Institutes of Health (RR024150)
National Center for Research Resources (RR-024150, UL1RR024150)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Keywords: fibromyalgia, fatigue, chronic widespread pain, fatigue analysis, fatigue treatment, symptom comorbidity, unrefreshing sleep, anxiety, depression, cognitive difficulties, fatigue mechanisms, PROMIS, OMERACT, patient-reported outcome measures
MeSH terms: Fatigue, Fibromyalgia, Humans, Pain

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Beyond pain in fibromyalgia: Insights into the symptom of fatigue

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