0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Clinical Crossroads |

Fibromyalgia:  A Clinical Review

Daniel J. Clauw, MD1
[+] Author Affiliations
1Professor of Anesthesiology, Medicine (Rheumatology), and Psychiatry and Director, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor
JAMA. 2014;311(15):1547-1555. doi:10.1001/jama.2014.3266.
Text Size: A A A
Published online

Importance  Fibromyalgia is present in as much as 2% to 8% of the population, is characterized by widespread pain, and is often accompanied by fatigue, memory problems, and sleep disturbances.

Objective  To review the epidemiology, pathophysiology, diagnosis, and treatment of fibromyalgia.

Evidence Review  The medical literature on fibromyalgia was reviewed from 1955 to March 2014 via MEDLINE and the Cochrane Central Registry of Controlled Trials, with an emphasis on meta-analyses and contemporary evidence-based treatment guidelines. Treatment recommendations are based on the most recent evidence-based guidelines from the Canadian Pain Society and graded from 1 to 5 based on the level of available evidence.

Findings  Numerous treatments are available for managing fibromyalgia that are supported by high-quality evidence. These include nonpharmacological therapies (education, exercise, cognitive behavioral therapy) and pharmacological therapies (tricyclics, serotonin norepinephrine reuptake inhibitors, and gabapentinoids).

Conclusions and Relevance  Fibromyalgia and other “centralized” pain states are much better understood now than ever before. Fibromyalgia may be considered as a discrete diagnosis or as a constellation of symptoms characterized by central nervous system pain amplification with concomitant fatigue, memory problems, and sleep and mood disturbances. Effective treatment for fibromyalgia is now possible.

Figures in this Article

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Place holder to copy figure label and caption
Figure.
Example of a Patient Self-report Survey for the Assessment of Fibromyalgia Based on Criteria in the 2011 Modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia7

ACR indicates American College of Rheumatology. Scoring information is shown in blue. The possible score ranges from 0 to 31 points; a score ≥13 points is consistent with a diagnosis of fibromyalgia. Additional scoring information and a printer-ready version of this survey that patients can complete are available online (eFigure 1 and eFigure 2 in the Supplement).

Graphic Jump Location

Tables

References

CME


You need to register in order to view this quiz.
Submit a Response

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 4

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Related Multimedia

JAMA Report Video

Author Video Interviews

Author Interview

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com
brightcove.createExperiences();