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Continuing Education in Anaesthesia, Critical Care & Pain Advance Access originally published online on August 30, 2009
Continuing Education in Anaesthesia, Critical Care & Pain 2009 9(5):162-166; doi:10.1093/bjaceaccp/mkp026
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© The Author [2009]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Pain and fibromyalgia

Jatin D Dedhia, DA DNB FRCA
SpR in Anaesthetics
University Hospitals of Leicester NHS Trust
Leicester Royal Infirmary
Leicester LE5 1WW, UK

Margaret E Bone, DA FRCA FFPMRCA
Consultant in Pain Medicine
University Hospitals of Leicester NHS Trust
Leicester Royal Infirmary
Leicester LE5 1WW, UK
Tel: +44 116 2585253
Fax: +44 116 2586261
E-mail: margaret.bone@uhl-tr.nhs.uk (for correspondence)

The first 150 words of the full text of this article appear below.


Key points

Fibromyalgia is a common chronic pain syndrome characterized by widespread pain, tenderness, and generalized hypersensitivity to painful stimuli.
Pain, fatigue, and sleep disturbance are present in most patients with this condition.
The pathophysiology is not well understood. Central sensitization, abnormalities in descending inhibitory pain pathways, neurotransmitter release, neurohumoral dysfunction, and psychological abnormalities are suggested aetiological mechanisms.
Diagnosis is based on the clinical criteria set out by the American College of Rheumatology, physical examination, and exclusion of other causes for symptoms attributed to fibromyalgia.
The treatment of this syndrome should be individualized and includes pharmacological and other therapies.

 

Fibromyalgia is a common chronic non-inflammatory pain syndrome characterized by widespread, often disabling pain and tenderness, stiffness, fatigue, and poor sleep. Symptoms of fibromyalgia were first reported in the nineteenth century when it was described as ‘neurasthenia’ and ‘muscular rheumatism’. In 1904, Gower renamed the condition ‘fibrositis’ and this remained in . . . [Full Text of this Article]


   Incidence
 

   Definition
 

   Clinical features
 
Co-existing conditions


   Pathophysiology
 
Central sensitization

Descending inhibitory pain pathway dysfunction

Biochemical factors

Biogenic amines

Substance P and amino acid neurotransmitters

Neurohumoral dysfunction

Behavioural and psychological factors

Regional central nervous system blood flow

Abnormal muscle energy metabolism


   Trigger factors for fibromyalgia
 

   Diagnosis
 
History

Assessment of symptoms

Pain

Fatigue

Sleep

Investigations


   Treatment of fibromyalgia
 
General measures

Oral pharmacological therapy

Trigger point injections

I.V. lidocaine

Non-pharmacological measures

Exercise

Cognitive behavioural therapy

Complementary therapies


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