An Update on Fibromyalgia Syndrome: The Multimodal Therapeutic Approach

Abstract

Fibromyalgia is a chronic, musculoskeletal, noninflammatory pain disorder. Patients frequently suffer from sleep disturbances, headaches, anxiety, morning stiffness, and a poor sense of well-being. It is estimated that approximately 6 million Americans live with this condition. Fibromyalgia is characterized by the presence of at least 11 tender points, as well as widespread bilateral pain for at least 3 months. If left untreated, it may lead to a significant impairment in patients' quality of life or even disability. Although the exact pathophysiology of fibromyalgia remains a source of speculation, several treatment modalities are available to patients with this condition. Among nonpharmacological options, cognitive-behavioral therapy, patient education, exercise, physical therapy, and diet have all been found effective in reducing the symptoms of fibromyalgia. Pregabalin, a second-generation anticonvulsant, and duloxetine (a selective serotonin and norepinephrine reuptake inhibitor) are the only pharmacological agents approved by the Food and Drug Administration for the treatment of fibromyalgia. However, other medications such as tricyclic antidepressants, selective serotonin reuptake inhibitors, anticonvulsants, and tramadol have been investigated in clinical trials and shown to be effective treatment options. Currently, the recommended management strategy for patients with fibromyalgia is a combination of pharmacological and nonpharmacological treatment modalities.