Information

Fibromyalgia is one of the most common types of chronic pain. It affects over 5 million patients in the United States alone. The etiology of fibromyalgia remains a mystery. However, there have been substantial gains in standardizing diagnosis and provisions for treatment recommendations both non-pharmacologic and the FDA approval of three therapeutic options. There are approved diagnostic criteria that have recently been revised to include common comorbidities such as depression, fatigue, headaches and insomnia. The hallmark of pain lasting greater than or equal to three months is seemingly widespread and not specific to one region. The myofascial tender point exam has also undergone additional attention to standardize assessment with equal applied pressure of 21 sites, three of which are control sites and should not be painful. It is important to treat the coinciding processes and simultaneously address the fibromyalgia syndrome. Making the appropriate diagnosis of FM early helps improve patient satisfaction and reduces healthcare utilization. There appears to be a spectrum of severity with leads to selective treatment recommendations as not everyone needs pharmacologic agents. The literature does not support treating fibromyalgia with daily narcotic therapies, and in fact, it can further precipitate rebound or worsening pain symptoms in many cases. Kenny Barrow, PAC, has taken an interest in the appropriate diagnosis and treatment of patients with fibromyalgia.