Monday, February 25, 2008

Fibromyalgia is not a rheumatological disease but a central pain syndrome

According to a Medscape video editorial:

In 1990, The American College of Rheumatology established diagnostic criteria for fibromyalgia based on the scoring of 18 potential tender points (pain on palpation with a 4-kg force, pain at 11 of 18 sites is necessary to meet the criteria). "It turns out, however, that these tender points have nothing to do with fibromyalgia. Biopsy of the tender points shows no pathologic changes, and numerous studies have not shown any abnormalities in the musculoskeletal tissues that are painful.

Current evidence points to a neurologic disorder of central pain processing. We will no longer need to refer our fibromyalgia patients to the rheumatologist."

Some doctors doubt if fibromyalgia truly exists but the patient symptoms are real and should be addressed. Duloxetine (Cymbalta) and pregabalin (Lyrica) have been used with some success to treat this disorder. Lyrica is the first and only FDA-approved medication for fibromyalgia therapy.

References:

Fibromyalgia Is Not a Rheumatologic Disease Anymore. George T. Griffing, MD. The Medscape Journal of Medicine. Webcast Video Editorials.
Pharmacotherapy of Fibromyalgia - Medscape review, 2011.
Treating Fibromyalgia. AFP, 2000.
Fibromyalgia. eMedicine, Aug 15, 2007.
Sexual dysfunction is common in patients with fibromyalgia - reported by 87% of females and 76% of males http://goo.gl/EsVTx
Image source: Wikipedia, Gray's Anatomy, public domain.

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