Fibromyalgia is a chronic widespread pain disorder estimated to affect 2% to 5% of the US adult population and 0.5% to 5% of other Western populations.
In addition to widespread pain present for more than 3 months, patients with fibromyalgia often report fatigue, nonrestorative sleep, cognitive dysfunction, stiffness, and mood disturbance.
With growing recognition of fibromyalgia by patients and health care professionals, more people are seeking medical help for chronic pain conditions and making frequent visits to their health care practitioner.
This has resulted in fibromyalgia becoming a clinical problem commonly seen in primary care and an economic burden on health care resources.
The management of patients with fibromyalgia in the primary care setting may be challenging for several reasons. Although there is increasing evidence about the underlying pathophysiologic mechanisms involved in fibromyalgia,
clinicians may find it difficult to communicate this emerging information to their patients. Also, many clinicians report difficulty in identifying and diagnosing fibromyalgia.
Finally, patients with fibromyalgia are sometimes perceived as difficult to treat,
especially in the primary care office where time and resources may be limited for complex presenting problems. This review is the third and final installment of a series of concise reviews that addresses challenges in fibromyalgia diagnosis, treatment, and management. The series was developed by the FibroCollaborative, an initiative organized and funded by Pfizer in which a diverse group of experts on fibromyalgia provided state-of-the-art information on the understanding, assessment, and treatment of fibromyalgia. Clauw et al
presented an update on pathophysiologic mechanisms in fibromyalgia. Arnold et al
described an approach to the differential diagnosis of fibromyalgia in primary care. This final review provides a framework for primary care providers (PCPs) to treat patients with fibromyalgia effectively as part of a multidisciplinary approach with the goal of improving patient education, symptom management, health status, and outcomes. The framework is similar to the integrated approach taken in the long-term care of other chronic health conditions, such as diabetes, asthma, and hypertension.