Fighting fibromyalgia: Five key issues
ABSTRACT: Physicians treating patients with fibromyalgia syndrome (FMS) should rule out coexisting disorders and establish possible inducing factors. They can work with patients to address their symptoms by providing patient education, instilling a sense of self-worth, advising avoidance of disability and narcotic medications, offering instruction in sleep hygiene, establishing anxiety reduction measures, and recommending an exercise program. Patients who have special needs and refractory cases may benefit from referral to a musculoskeletal specialist. Physicians can best improve patients' prognosis and quality of life by addressing several issues: whether the FMS is primary or secondary, whether there are underlying psychosocial stressors, whether pain is regional or widespread, how to approach exercise for therapy, and determining which medications to use. (J Musculoskel Med. 2008;25:172-184)