Fibromyalgia: A Clinical Review
IMPORTANCE Fibromyalgia is present in as much as 2% to 8% of the population, is characterized by widespread pain, and is often accompanied by fatigue, memory problems, and sleep disturbances. OBJECTIVE To review the epidemiology, pathophysiology, diagnosis, and treatment of fibromyalgia. EVIDENCE RE...
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| Veröffentlicht in: | JAMA : the journal of the American Medical Association 2014-04, Vol.311 (15), p.1547-1555 |
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| creator | Clauw, Daniel J |
| description | IMPORTANCE Fibromyalgia is present in as much as 2% to 8% of the population, is characterized by widespread pain, and is often accompanied by fatigue, memory problems, and sleep disturbances. OBJECTIVE To review the epidemiology, pathophysiology, diagnosis, and treatment of fibromyalgia. EVIDENCE REVIEW The medical literature on fibromyalgia was reviewed from 1955 to March 2014 via MEDLINE and the Cochrane Central Registry of Controlled Trials, with an emphasis on meta-analyses and contemporary evidence-based treatment guidelines. Treatment recommendations are based on the most recent evidence-based guidelines from the Canadian Pain Society and graded from 1 to 5 based on the level of available evidence. FINDINGS Numerous treatments are available for managing fibromyalgia that are supported by high-quality evidence. These include nonpharmacological therapies (education, exercise, cognitive behavioral therapy) and pharmacological therapies (tricyclics, serotonin norepinephrine reuptake inhibitors, and gabapentinoids). CONCLUSIONS AND RELEVANCE Fibromyalgia and other “centralized” pain states are much better understood now than ever before. Fibromyalgia may be considered as a discrete diagnosis or as a constellation of symptoms characterized by central nervous system pain amplification with concomitant fatigue, memory problems, and sleep and mood disturbances. Effective treatment for fibromyalgia is now possible. |
| doi_str_mv | 10.1001/jama.2014.3266 |
| format | Article |
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OBJECTIVE To review the epidemiology, pathophysiology, diagnosis, and treatment of fibromyalgia. EVIDENCE REVIEW The medical literature on fibromyalgia was reviewed from 1955 to March 2014 via MEDLINE and the Cochrane Central Registry of Controlled Trials, with an emphasis on meta-analyses and contemporary evidence-based treatment guidelines. Treatment recommendations are based on the most recent evidence-based guidelines from the Canadian Pain Society and graded from 1 to 5 based on the level of available evidence. FINDINGS Numerous treatments are available for managing fibromyalgia that are supported by high-quality evidence. These include nonpharmacological therapies (education, exercise, cognitive behavioral therapy) and pharmacological therapies (tricyclics, serotonin norepinephrine reuptake inhibitors, and gabapentinoids). CONCLUSIONS AND RELEVANCE Fibromyalgia and other “centralized” pain states are much better understood now than ever before. Fibromyalgia may be considered as a discrete diagnosis or as a constellation of symptoms characterized by central nervous system pain amplification with concomitant fatigue, memory problems, and sleep and mood disturbances. Effective treatment for fibromyalgia is now possible.</description><identifier>ISSN: 0098-7484</identifier><identifier>ISSN: 1538-3598</identifier><identifier>EISSN: 1538-3598</identifier><identifier>DOI: 10.1001/jama.2014.3266</identifier><identifier>PMID: 24737367</identifier><identifier>CODEN: JAMAAP</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Biological and medical sciences ; Clinical outcomes ; Diseases of the osteoarticular system ; Epidemiology ; Evidence-Based Medicine ; Fibromyalgia ; Fibromyalgia - complications ; Fibromyalgia - diagnosis ; Fibromyalgia - epidemiology ; Fibromyalgia - therapy ; General aspects ; Humans ; Medical diagnosis ; Medical sciences ; Medical treatment ; Miscellaneous. 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OBJECTIVE To review the epidemiology, pathophysiology, diagnosis, and treatment of fibromyalgia. EVIDENCE REVIEW The medical literature on fibromyalgia was reviewed from 1955 to March 2014 via MEDLINE and the Cochrane Central Registry of Controlled Trials, with an emphasis on meta-analyses and contemporary evidence-based treatment guidelines. Treatment recommendations are based on the most recent evidence-based guidelines from the Canadian Pain Society and graded from 1 to 5 based on the level of available evidence. FINDINGS Numerous treatments are available for managing fibromyalgia that are supported by high-quality evidence. These include nonpharmacological therapies (education, exercise, cognitive behavioral therapy) and pharmacological therapies (tricyclics, serotonin norepinephrine reuptake inhibitors, and gabapentinoids). CONCLUSIONS AND RELEVANCE Fibromyalgia and other “centralized” pain states are much better understood now than ever before. Fibromyalgia may be considered as a discrete diagnosis or as a constellation of symptoms characterized by central nervous system pain amplification with concomitant fatigue, memory problems, and sleep and mood disturbances. Effective treatment for fibromyalgia is now possible.</description><subject>Biological and medical sciences</subject><subject>Clinical outcomes</subject><subject>Diseases of the osteoarticular system</subject><subject>Epidemiology</subject><subject>Evidence-Based Medicine</subject><subject>Fibromyalgia</subject><subject>Fibromyalgia - complications</subject><subject>Fibromyalgia - diagnosis</subject><subject>Fibromyalgia - epidemiology</subject><subject>Fibromyalgia - therapy</subject><subject>General aspects</subject><subject>Humans</subject><subject>Medical diagnosis</subject><subject>Medical sciences</subject><subject>Medical treatment</subject><subject>Miscellaneous. 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| source | MEDLINE; American Medical Association Journals |
| subjects | Biological and medical sciences Clinical outcomes Diseases of the osteoarticular system Epidemiology Evidence-Based Medicine Fibromyalgia Fibromyalgia - complications Fibromyalgia - diagnosis Fibromyalgia - epidemiology Fibromyalgia - therapy General aspects Humans Medical diagnosis Medical sciences Medical treatment Miscellaneous. Osteoarticular involvement in other diseases Practice Guidelines as Topic |
| title | Fibromyalgia: A Clinical Review |
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