A common disorder characterized by chronic widespread musculoskeletal pain, aching, stiffness, paresthesia, disturbed sleep, and easy fatigability along with multiple tender points. More common in women than in men. Diagnosis is made clinically; evaluation reveals soft tissue tender points but no objective joint abnormalities by examination, laboratory, or radiograph.
Treatment: Fibromyalgia Pregabalin, duloxetine, and milnacipran have shown benefit for fibromyalgia. Tricyclics for sleep disorder, local measures (heat, massage), physical conditioning, and cognitive-behavioral strategies to improve sleep hygiene. |
Section 12. Allergy, Clinical Immunology, and Rheumatology