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Pain in fibromyalgia patients

Fabiola Rostro, María J Cancelo and Camil Castelo-Branco3

Fibromyalgia is defined by widespread pain and 11 of 18 tender points, often accompanied by symptoms such as fatigue, sleep disturbance, headache, irritable bowel syndrome and mood disorder. Fibromyalgia’s diagnosis is eminently clinical, and currently there are no specific laboratory or technical tests. The major role in pathogenesis appears to be central and available evidence points toward dysregulation of neurotransmitter function and central pain sensitization as fundamental mechanisms. There is no evidence of abnormalities in muscle and tendon. The goal of therapy in fibromyalgia is to treat pain, and reduce physical function and sleep disturbance. The treatment of patients with fibromyalgia is difficult, and no single treatment has been successful. Here, actual evidence of the effects of pharmacological and nonpharmacological interventions on pain is summarized. Tricyclic agents, selective serotonin-reuptake inhibitors, muscle relaxants, anti-epileptics drugs, aerobic exercises, psychological treatment, patient education and combined therapies can reduce symptoms and disability effectively.