Management of fibromyalgia syndrome: review of evidence

Akiko Okifuji, Bradford D Hare, Akiko Okifuji, Bradford D Hare

Abstract

Fibromyalgia syndrome (FMS) is a common chronic musculoskeletal pain disorder of unknown etiology and characterized by generalized body pain, hyperalgesia, and other functional and emotional comorbidities. Despite extensive research, no treatment modality is effective for all FMS patients. In this paper, we briefly review the history of FMS and diagnostic criteria, and potential pathophysiological mechanisms including central pain modulation, neurotransmitters, sympatho-adrenal and hypothalamic-pituitary-adrenal systems and peripheral muscle issues. The primary focus of the paper is to review treatment options for managing fibromyalgia symptoms. We will discuss FDA-approved medications and other pharmacologic agents, and non-pharmacologic treatments that have shown promising effects.

Figures

Fig. 1
Fig. 1
Percentage of patients reporting >30% pain reduction by dose for pregabalin [56], duloxetine [60], and milnacipran [69] versus placebo. BID twice daily, QD every day

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