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A 35-Year-Old Woman with Whole Body Pain: Fibromyalgia

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Practical Chronic Pain Management

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Abstract

Fibromyalgia is a disease that can significantly impact the quality of life of numerous patients. Patients present with widespread pain in addition to associated symptoms such as sleep disturbances, cognitive dysfunction, depression, anxiety, and fatigue. The disease is more prevalent among women. While there is no cure for fibromyalgia, symptoms can be decreased with the appropriate treatment plan. Treatment involves a stepwise approach including patient education, medications, and physical and psychological therapies. Patients who adhere to their treatment plans have the best chance of successful recovery.

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References

  1. Smythe HA, Moldofsky H. Two contributions to understanding of the “fibrositis” syndrome. Bull Rheum Dis. 1977–1978;28(1):928–31.

    PubMed  Google Scholar 

  2. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990;33:160–72.

    CAS  PubMed  Google Scholar 

  3. Fitzcharles MA, Boulos P. Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Rheumatology (Oxford). 2003;42(2):263–7.

    Google Scholar 

  4. Bennett RM. Clinical manifestations and diagnosis of fibromyalgia. Rheum Dis Clin N Am. 2009;35(2):215–32.

    Google Scholar 

  5. Mease P. Fibromyalgia syndrome: review of clinical presentation, pathogenesis, outcomemeasures, and treatment. J Rheumatol Suppl 2005;75:6–21. Review. Erratum in: J Rheumatol Suppl. 2005;32(10):2063.

    Google Scholar 

  6. Wolfe F, Clauw D, Fitzcharles MA, Goldenberg D, Hauser W, Katz R, Russel A, Russel I, Walitt B. 2016 revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum. 2016;46(3):319–29.

    PubMed  Google Scholar 

  7. Sarzi-Puttini P, Atzeni F, Mease PJ. Chronic widespread pain: from the peripheral to central evolution. Best Pract Res Clin Rheumatol. 2011;25(2):133–9.

    PubMed  Google Scholar 

  8. Schmidt-Wilcke T, Clauw DJ. Fibromyalgia: from pathophysiology to therapy. Nat Rev Rheumatol. 2011;7(9):518.

    PubMed  Google Scholar 

  9. Goldenberg DL. Do infections trigger fibromyalgia? Arthritis Rheum. 1993;36:1489.

    CAS  PubMed  Google Scholar 

  10. Petzke F, Clauw DJ, Ambrose K, Khine A, Gracely RH. Increased pain sensitivity in fibromyalgia: effects of stimulus type and mode of presentation. Pain. 2003;105(3):403–13.

    PubMed  Google Scholar 

  11. Geisser ME, Glass JM, Rajcevska LD, Clauw DJ, Williams DA, Kileny PR, et al. A psychophysical study of auditory and pressure sensitivity in patients with fibromyalgia and healthy controls. J Pain. 2008;9(5):417–22.

    PubMed  Google Scholar 

  12. Gracely RH, Petzke F, Wolf JM, Clauw DJ. Functional magnetic resonance imaging evidence of augmented central pain processing in fibromyalgia. Arthritiis Rheum. 2002;46:1333–43.

    Google Scholar 

  13. Giesecke T, Gracely R, Grant MA, Nachemson A, Petzke F, Williams D, Clauw D. Evidence of augmented central pain processing in idiopathic low back pain. Arthritis Rheum. 2004;50:613–23.

    PubMed  Google Scholar 

  14. Cook DB, Lange G, Ciccone DS, Liu WC, Steffener J, Natelson BH. Functinal imaging of pain in patients with primary fibromyalgia. J Rheumatol. 2004;31:364–78.

    PubMed  Google Scholar 

  15. Jensen KB, Loitoile R, Kosek E, Petzke F, Carville S, Fransson P, Marcus H, Williams SCR, Choy E, Mainguy Y, et al. Patients with fibromyalgia display less functional connectivity in the brain’s pain inhibitory network. Mol Pain. 2012;8:32.

    PubMed  PubMed Central  Google Scholar 

  16. Harte SE, Ichesco E, Hampson JP, Peltier SJ, Schmidt-Wilcke T, Clauw DJ, Harris RE. Pharmacologic attenuation of cross-modal sensory augmentation within the chronic pain insula. Pain. 2016;157:1933.

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Schmidt-Wilke T, Diers M. New insights into the pathophysiology and treatment of fibromyalgia. Biomedicine. 2017;5(22):E22.

    Google Scholar 

  18. Napadow V, Harris RE. What has functional connectivity and chemical neuroimaging in fibromyalgia taught us about the mechanisms and management of “centralized” pain? Arthritis Res Ther. 2014;16:425.

    PubMed  PubMed Central  Google Scholar 

  19. Gürsoy S, Erdal E, Herken H, Madenci E, Alaşehirli B, Erdal N. Significance of catechol- O-methyltransferase gene polymorphism in fibromyalgia syndrome. Rheumatol Int. 2003;23(3):104–7.

    PubMed  Google Scholar 

  20. Harris RE, Clauw DJ, Scott DJ, McLean SA, Gracely RH, Zubieta JK. Decreased central mu-opioid receptor availability in fibromyalgia. J Neurosci. 2007;27(37):10000–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  21. Clauw DJ. Fibromyalgia: a clinical review. JAMA. 2014;311:1547–55.

    PubMed  Google Scholar 

  22. Arnold L, Clauw D, Dunegan J, Turk D. A framework for fibromyalgia management for primary care providers. Mayo Clinic Proc. 2012;87(5):488–96.

    Google Scholar 

  23. Arnold LM. Biology and therapy of fibromyalgia. New therapies in fibromyalgia. Arthritis Res Ther. 2006;8:212.

    PubMed  PubMed Central  Google Scholar 

  24. White KP, Speechley M, Harth M, Ostbye T. Comparing self-reported function and work disability in 100 community cases of fibromyalgia syndrome versus controls in London, Ontario: the London Fibromyalgia Epidemiology Study. Arthritis Rheum. 1999;42(1):76–83.

    CAS  PubMed  Google Scholar 

  25. Blyth FM, March LM, Brnabic AJM, Jorm LR, Williamson M, Cousins MJ. Chronic pain in Australia: a prevalence study. Pain. 2001;89:127–34.

    CAS  PubMed  Google Scholar 

  26. Harker, J.; Reid, K.J.; Bekkering, G.E.; Kellen, E.; Malgorzata, M.; Riemsma, R.; Worthy, G.; Misso, K.; Kleijnen, J. Epidemiology of chronic pain in Denmark and Sweden. Pain Res. Treat 2012; Art ID 371248:1–30.

    Google Scholar 

  27. Manchikanti L, Singh V, Datta S, Cohen SP, Hirsch J. A comprehensive review of epidemiology, scope, and impact of spinal pain. Pain Physician. 2009;12:E35–70.

    PubMed  Google Scholar 

  28. Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheumatol. 1995;38:19–28.

    CAS  Google Scholar 

  29. Assumpção A, Cavalcante A, Capela C, Al E. Prevalence of fibromyalgia in a low socioeconomic status population. BMC Musculoskelet Disord. 2009;10:64–70.

    PubMed  PubMed Central  Google Scholar 

  30. Baskila D, Neumann I. Fibromyalgia syndrome (FM) and nonarticular tenderness in relatives of patients with FM. J Rheumatol. 1997;24(5):941–0.

    Google Scholar 

  31. Chen J, Mckenzie-Brown AM. The epidemiology and prevalence of fibromyalgia syndrome. In: Lawson E, Wallace M, editors. Fibromyalgia: clinical guidelines and treatments. Switzerland: Springer Publishing; 2015.. Chapter 1.

    Google Scholar 

  32. Goldenberg D. Diagnosis and differential diagnosis of fibromyalgia. Am J Med. 2009;122(12):S14–21.

    PubMed  Google Scholar 

  33. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, Russell AS, Winfield JB, Yunus MB. Ther American college of rheumatology preliminary criteria for fibromyalgia and measurement of symptoms severity. Arthritis Care Res. 2010;62(5):600–10.

    Google Scholar 

  34. Macfarlane GJ, Kronisch C, Dean LE, Atzeni F, Häuser W, Fluß E, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2017;76:318–28.

    CAS  PubMed  Google Scholar 

  35. Rico-Villademoros F, Slim M, Calandre EP. Amitriptyline for the treatment of fibromyalgia: a comprehensive review. Expert Rev Neurother. 2015;15:1123–50.

    CAS  PubMed  Google Scholar 

  36. Kwiatek R. Treatment of fibromyalgia. Aust Prescr. 2017;40:179–83.

    PubMed  PubMed Central  Google Scholar 

  37. Lunn MP, Hughes RA, Wiffen PJ. Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia. Cochrane Database Syst Rev. 2014;1:CD007115.

    Google Scholar 

  38. Cording M, Derry S, Phillips T, Moore RA, Wiffen PJ. Milnacipran for pain in fibromyalgia in adults. Cochrane Database Syst Rev. 2015;10:CD008244.

    Google Scholar 

  39. Taylor CP. Mechanisms of analgesia by gabapentin and pregabalin—Calcium channel α2-Δ [cavα2-Δ] ligands. Pain. 2009;142:13–6.

    CAS  PubMed  Google Scholar 

  40. Crofford LJ, Rowbotham MC, Mease PJ, Russell IJ, Dworkin RH, Corbin AE, Young JP Jr, LaMoreaux LK, Martin SA, Sharma U. Pregabalin for the treatment of fibromyalgia syndrome: results of a randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2005;52:1264–73.

    CAS  PubMed  Google Scholar 

  41. Moore RA, Straube S, Wiffen PJ, Derry S, McQuay HJ. Pregabalin for acute and chronic pain in adults. Cochrane Database Syst Rev. 2009;

    Google Scholar 

  42. Üçeyler N, Sommer C, Walitt B, Häuser W. Anticonvulsants for fibromyalgia. Cochrane Database Syst Rev. 2013;10:CD010782.

    Google Scholar 

  43. Cooper TE, Derry S, Wiffen PJ, Moore RA. Gabapentin for fibromyalgia in adults. Cochrane Database Syst Rev. 2017;(1):CD012188.

    Google Scholar 

  44. Walitt B, Urrútia G, Nishishinya MB, Cantrell SE, Häuser W. Selective serotonin reuptake inhibitors for fibromyalgia syndrome. Cochrane Database Syst Rev. 2015;6

    Google Scholar 

  45. Littlejohn GO, Guymer EK, Ngian GS. Is there a role for opioids in the treatment of fibromyalgia? Pain Manag. 2016;6:347–55.

    PubMed  Google Scholar 

  46. Kia S, Choy E. Update on treatment guidelines in fibromyalgia syndrome with focus on pharmacology. Biomedicine. 2017;5(2):20.

    Google Scholar 

  47. Derry S, Wiffen PJ, Häuser W, Mücke M, Tölle TR, Bell RF, Moore RA. Oral nonsteroidal anti-inflammatory drugs for fibromyalgia in adults. Cochrane Lib. 2016; https://doi.org/10.1002/14651858.CD012332.

  48. Bennett RM, Kamin M, Karim R, Rosenthal N. Tramadol and acetaminophen combination tablets in the treatment of fibromyalgia pain: a double-blind, randomized, placebo-controlled study. Am J Med. 2003;114:537–45.

    CAS  PubMed  Google Scholar 

  49. Bidonde J, Busch A, Schachter C, Overend T, Kim S, et al. Aerobic exercise training for adults with fibromyalgia. Cochrane Database Syst Rev. 2017;(6):CD012700.

    Google Scholar 

  50. Sosa-Reina MD, Nunez-Nagy S, Gallego-Izquierdo T, Pecos-Martin D, Monserrat J, Alvarez-Mon M. Effectiveness of therapeutic exercise in fibromyalagia syndrome: a systematic review and meta-analysis of randomized clinical trials. Hindawi Biomed Research International. 2017; Art ID 2356346:1–14.

    Google Scholar 

  51. Hauser W, Walitt B, Fitzcharles MA, Sommer C. Review of pharmacological therapies in fibromyalgia syndrome. Arthritis Res Ther. 2014;16:201.

    PubMed  PubMed Central  Google Scholar 

  52. Walitt B, Klose P, Fitzcharles MA, et al. Cannabinoids for fibromyalgia. Cochrane Database Syst Rev. 2016;7:CD011694.

    PubMed  Google Scholar 

  53. Younger J, Noor N, McCue R, Mackey S. Low-dose naltrexone for the treatment of fibromyalgia: findings of a small, randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing daily pain levels. Arthritis Rheumatol. 2013;65(2):529–38.

    CAS  Google Scholar 

  54. Hutchinson MR, Zhang Y, Brown K, Coats BD, Shridhar M, Sholar PW, et al. Non-stereoselective reversal of neuropathic pain by naloxone and naltrexone: involvement of toll-like receptor 4 (TLR4). Eur J Neurosci. 2008;28:20–9.

    PubMed  PubMed Central  Google Scholar 

  55. Mattioli TA, Miline B, Cahill CM. Ultra-low dose naltrexone attenuates chronic morphine-induced gliosis in rats. Mol Pain. 2010;6:22.

    PubMed  PubMed Central  Google Scholar 

  56. Knijink LM, Dussan-Sarria JA, Rozisky JR, et al. Repetitive transcranial magnetic stimulation for fibromyalgia: a systematic review and meta-analysis. Pain Pract. 2016;16(3):294–304.

    Google Scholar 

  57. Woolf C. Central sensitization: implications for the diagnosis and treatment of pain. 2011;152(S3):S2–15.

    Google Scholar 

  58. Wolfe F, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res. 2010;62(5):600–10.

    Google Scholar 

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Authors and Affiliations

  1. Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA, USA

    Lynn R. Kohan & Xiaoying Zhu

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  1. Lynn R. Kohan
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  2. Xiaoying Zhu
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Correspondence to Lynn R. Kohan .

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Editors and Affiliations

  1. Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL, USA

    Tariq Malik

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Kohan, L.R., Zhu, X. (2020). A 35-Year-Old Woman with Whole Body Pain: Fibromyalgia. In: Malik, T. (eds) Practical Chronic Pain Management. Springer, Cham. https://doi.org/10.1007/978-3-030-46675-6_41

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  • DOI: https://doi.org/10.1007/978-3-030-46675-6_41

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