Abstract
Fibromyalgia (FM) is a syndrome that does not present a well-defined underlying organic disease. FM is a condition which has been associated with diseases such as infections, diabetes, psychiatric or neurological disorders, rheumatic pathologies, and is a disorder that rather than diagnosis of exclusion requires positive diagnosis. A multidimensional approach is required for the management of FM, including pain management, pharmacological therapies, behavioral therapy, patient education, and exercise. The purpose of this review is to summarize the recent advances in classification criteria and diagnostic criteria for FM as well as to explore pharmacotherapy and the use of alternative therapies including the use of plant bioactive molecules.
Highlights
Fibromyalgia (FM) is a syndrome that does not present a well-defined underlying organic disease
A recent systematic review shows that a minority of people with moderate to severe pain due to FM treated with a daily dose of 300 to 600 mg of pregabalin had a reduction of pain intensity over a follow-up period of 12 to 26 weeks, with tolerable adverse effects [84]
Diagnosis of FM is based on clinical feature and criteria that still lack either a gold standard or at least supportive laboratory findings
Summary
Fibromyalgia (FM) (earlier considered to be fibrositis, to stress the role of peripheral inflammation in the pathogenesis) is a syndrome that does not present a well-defined underlying organic disease. FM is currently recognized by the widespread pain index (which divides the body into 19 regions and scores how many regions are reported as painful) and a symptom severity score (SSS) that assesses cognitive symptoms, unrefreshing sleep and severity of fatigue [6]. It is not clear what causes FM and diagnosing assist the patients to face polysymptomatic distress, thereby reducing doubt and fear which are main psychological factors contributing to this central amplification mechanism [7]. An update on diagnosis and therapy of FM is provided along the discussion on the possibility of using pharmacological drugs, bioactive natural substances and alternative therapies to alleviate the symptomatology in combination or as alternative remedies to drugs
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