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Fibromyalgia Diagnosis

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Fibromyalgia

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Abstract

Fibromyalgia (FM) is defined as a chronic widespread pain associated with fatigue, insomnia, stiffness, irritable bowel syndrome, and symptoms of anxiety and depression. It is seen in 2–4 % of the general population, with incidence higher among females than males (3.4 vs. 0.5 %). It is estimated to cost approximately US$ 2274 in the annual health-care service utilization for each individual FM patient. The pathogenesis of FM likely involves central sensitization leading to hyperalgesia and allodynia with attenuation of the descending inhibitory pathways. The diagnostic criteria have changed since the American College of Rheumatology (ACR) developed criteria in 1990. These original criteria included widespread pain for at least 3 months and tenderness to palpation in 11 of 18 specified tender points.

These broad criteria lead to confusion in diagnosing FM. A more rigorous definition for FM was developed by the ACR in 2010, and was further modified in 2011. Two key measures—the widespread pain index (WPI) and severity scale (SS)—are utilized in the new system. Evaluation includes pain assessment by way of a detailed history and physical examination including a neurological examination, sleep evaluation, and laboratory workup to rule out other disease states that may mimic FM. Diagnosis requires the presence of chronic widespread pain for at least 3 months, excess tenderness of soft tissues, absence of other conditions that may explain symptoms, and other associated clinical features. This chapter is focused on the diagnosis and evaluation of patients with FM.

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Author information

Authors and Affiliations

  1. Korunda Pain Management Center, 4513 Executive Drive, Naples, FL, 34229, USA

    Omar H. Henriquez MD

  2. Department of Anesthesiology, Division of Pain Management, Weill Cornell Medical College, New York, NY, USA

    Devin Peck MD

Authors
  1. Omar H. Henriquez MD
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  2. Devin Peck MD
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Correspondence to Devin Peck MD .

Editor information

Editors and Affiliations

  1. Voluntary Faculty, Department of Anesthesiology, Center for Pain Medicine, University of California San Diego,, Lexington, South Carolina, USA

    Erin Lawson, MD

  2. Professor of Clinical Anesthesiology,Chief, Division of Pain Medicine, Department of Anesthesiology, University of California San Diego, La Jolla, California, USA

    Mark S. Wallace, MD

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© 2015 Springer International Publishing Switzerland

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Henriquez, O., Peck, D. (2015). Fibromyalgia Diagnosis. In: Lawson, MD, E., Wallace, MD, M. (eds) Fibromyalgia. Springer, Cham. https://doi.org/10.1007/978-3-319-15820-4_2

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  • DOI: https://doi.org/10.1007/978-3-319-15820-4_2

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-15820-4

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