Fibromyalgia

Fibromyalgia syndrome is a frequent cause of chronic, widespread pain and affects up to 5% of the general population in industrial nations. Both genetics and the environment have been implicated in the development of fibromyalgia, and current research focuses on evaluating neurobiological, psychological, and behavioral factors that play a part in the disease pathogenesis. As we better understand how these factors interact to cause symptoms in groups of individuals, we can design treatment programs that are more effective in individual patients. For example, classes of drugs such as non-steroidal anti-inflammatory drugs (NSAIDs) and opioids which are quite effective for "peripheral" pain are typically ineffective for the "central" pain seen in fibromyalgia. Instead, tricyclic antidepressants (TCA) and other classes of antidepressants, antiseizure drugs, and a number of other neuroactive compounds seem to be more effective. In addition, non-pharmacological therapies such as aerobic exercise and cognitive behavioral therapy are reasonably effective, and frequently underutilized in clinical practice.