The main symptoms are pains presented in many parts of the body as well as tiredness [6]. Many people develop some of the symptoms covered below but the severity varies from person to person.

Other symptoms present in patients with fibromyalgia:

• Headache
• Irritable bladder (bringing about more frequent visits to the toilet)
• Painful periods (in some women with fibromyalgia)
• Restless leg syndrome (seen in about 1 in 5 individuals with this condition)
• Irritable bowel syndrome (this is seen commonly in people with fibromyalgia and there is abdominal pains, diarrhea, constipation and bloating)
• Feeling of pins and needles in toes and fingers
• Feeling of swollen hands and feet (in many cases the hands and feet are not actually swollen)
• Anxiety and depression (it is still not clear whether this is part of the symptoms of this condition or if it simply develops as a result of people being worried about this condition)
• Many people with fibromyalgia often have chronic fatigue syndrome/myalgic encephalomyelitis

• Pain

  Pain The main symptom of fibromyalgia is widespread pain. Although the pain may start in one area it can move around, and some activities, such as carrying groceries, can be particularly uncomfortable in the area involved. [healthnavigator.org.nz]

  Current diagnostic criteria refer to fibromyalgia pain as multisite pain. In contrast, the 1990 fibromyalgia diagnostic criteria defined fibromyalgia pain as chronic widespread pain. [healthline.com]

  It feels them as pain, where other people would not. This does not mean that the pain is not real — simply that the pain originates in the brain, not the muscle and bone. [healthdirect.gov.au]

  Living with a Chronic Disease Pain and Palliative Care Chronic Pain What is fibromyalgia? Fibromyalgia is a condition that causes pain in muscles and soft tissues all over the body. It is an ongoing (chronic) condition. [hopkinsmedicine.org]

• Fatigue

  A note from Cleveland Clinic Fibromyalgia symptoms — chronic fatigue and all-over body pain — can take a toll on your mental and physical well-being. [my.clevelandclinic.org]

  Other symptoms of fibromyalgia include:3,4,5 Extreme tiredness, called fatigue, that does not get better with sleep or rest Cognitive and memory problems (sometimes called “fibro fog”)3 Trouble sleeping6 Mood problems Morning fatigue Muscle fatigue, causing [womenshealth.gov]

  Anxiety and depression, in turn, can make pain and fatigue worse. Somatization Syndrome Some people with fibromyalgia feel extreme anxiety about a physical symptom – such as pain or fatigue. [arthritis.org]

  Capuron L, Welberg L, Heim C, et al: Cognitive dysfunction relates to subjective report of mental fatigue in patients with chronic fatigue syndrome. Neuropsychopharmacology 2006;31:1777-1784. [dx.doi.org]

  That’s why doctors must rule out other possible causes of symptoms like pain and fatigue before making a fibromyalgia diagnosis. Pain and fatigue are symptoms of many conditions, including chronic fatigue syndrome, rheumatoid arthritis, and lupus. [asahq.org]

• Chronic Fatigue Syndrome

  Komaroff AL: Clinical presentation of chronic fatigue syndrome. Ciba Found Symp 1993;173:43-54; discussion 54-61. Afari N, Buchwald D: Chronic fatigue syndrome: a review. Am J Psychiatry 2003;160:221-236. [dx.doi.org]

  Keywords Chronic Fatigue Syndrome Cognitive Dysfunction Chronic Pain Patient Mental Fatigue Chronic Fatigue Syndrome Patient These keywords were added by machine and not by the authors. [doi.org]

  Hypermobility & Fibromyalgia This site provides information and support for people with both joint hypermobility and fibromyalgia or chronic fatigue syndrome. [curlie.org]

  Fibromyalgia often co-exists with other conditions, such as: Irritable bowel syndrome Chronic fatigue syndrome Migraine and other types of headaches Interstitial cystitis or painful bladder syndrome Temporomandibular joint disorders Anxiety Depression [mayoclinic.org]

  It sometimes causes typical symptoms of viral hepatitis, including anorexia, malaise, and jaundice but may be asymptomatic... read more, and consider chronic fatigue syndrome Chronic Fatigue Syndrome Chronic fatigue syndrome (CFS, also called myalgic [msdmanuals.com]

• Weakness

  Besides variable proximal muscle weakness, myotonia, and precocious cataracts, muscle pain and stiffness are prominent presenting features of DM2. [ncbi.nlm.nih.gov]

  Another theory suggests that the disorder may be associated with changes in skeletal muscle metabolism, possibly caused by decreased blood flow, which could cause chronic fatigue and weakness. [web.archive.org]

  Do you always feel tired and weak? Do you have major sleep problems ? People with fibromyalgia syndrome deal with those precise problems. Practically no one can tell them what's wrong. [gastein.com]

  Fibromyalgia may cause: Generalized pain and tenderness Fatigue Weakness Poor sleep Reduced physical endurance Problems with concentration, thought or memory Factors that may trigger or worsen symptoms include: Weather changes, especially cold, damp weather [uvahealth.com]

• Excessive Daytime Sleepiness

  For many, the excessive daytime sleepiness makes it hard to keep with the demands of daily life. The cognitive effects of fibromyalgia can be just as challenging as the pain and fatigue. [technologynetworks.com]

  It has been approved by the FDA to treat excessive daytime sleepiness and cataplexy in narcolepsy. The distinction between GHB and sodium oxybate should be noted. [doi.org]

  Sodium oxybate, the sodium salt of GHB, was granted an Orphan Drug Status by the FDA for the treatment of cataplexy and excessive daytime sleepiness in patients with narcolepsy, which was classified as an orphan (rare) disease [ 54 ]. [ncbi.nlm.nih.gov]

  Randomized, double-blind, placebo-controlled crossover trial of modafinil in the treatment of excessive daytime sleepiness in narcolepsy. Neurology. 1997 Aug. 49(2):444-51. [Medline]. Schwartz TL, Rayancha S, Rashid A, et al. [emedicine.medscape.com]

• Non-Cardiac Chest Pain

  Fibromyalgia (FM) is a common, chronic, generalized pain syndrome of unknown origin. Although pain and tenderness are its defining features, fatigue, sleep disturbance, non-cardiac chest pain, depression and poor concentration are also common. [hopkinsarthritis.org]

  Typically, the problems are related to the muscles and ligaments surrounding the jaw joint and not necessarily the joint itself.23 Other Common Symptoms - Non-cardiac chest pain, acid reflux, irregular heart beat or palpitations, shortness of breath, [afsafund.org]

  Anxiety Atypical facial pain Atypical or non-cardiac chest pain Autoimmune disorder (self-diagnosed) Autonomic disorder (self-diagnosed) Black mold, toxic black mold (self-diagnosed) Brain fog, fibrofog Burning mouth syndrome Burning tongue Candida or [ncbi.nlm.nih.gov]

• Abdominal Pain

  Signs and symptoms of fibromyalgia vary, but can include: Moderate to severe fatigue Tender spots of pain in the muscles Decreased muscle endurance Sleep problems Depressed mood or anxiety Abdominal pain and bloating Diarrhea alternated with constipation [umiamihealth.org]

  Other common symptoms of fibromyalgia include: Medium to severe tiredness (fatigue) Less exercise endurance Sleep problems at night Depressed mood Anxiety Headaches Irritable bowel symptoms, such as belly (abdominal) pain and bloating, diarrhea, and constipation [hopkinsmedicine.org]

  Tingling or numbness in hands and feet Pain in the face or jaw, including disorders of the jaw known as temporomandibular joint syndrome (also known as TMJ) Digestive problems, such as abdominal pain, bloating, constipation, and even irritable bowel syndrome [cdc.gov]

  People with fibromyalgia are more likely than the general public to have symptoms of other chronic conditions, such as irritable bowel syndrome, which can cause abdominal pain, cramps, and constipation or diarrhea. [nyulangone.org]

  The symptoms of the infestation include abdominal pain, weight loss, muscle pain, fever and joint pain. Most parasitic infestations can be treated effectively with medications including triclabendazole or praziquantel. [news-medical.net]

• Abdominal Cramps

  Symptoms may include: Bloating Nausea Abdominal cramps Diarrhea Constipation Indigestion Frequent passing of gas Difficulty swallowing (dysphagia) Frequent urination Frequent need to urinate (urinary urgency) Pain during urination (dysuria) Bladder spasms [verywellhealth.com]

• Chest Pain

  pain are common in FM patients; medications used to manage pain, inflammation, and gastrointestinal complaints confound the management of FM; and IBS affects smooth muscles and the parasympathetic nervous system, while FM patients have complaints of [ncbi.nlm.nih.gov]

  We also treat children with disabling amplified abdominal, head or chest pain that is not related to musculoskeletal pain. [chop.edu]

  After countless tests, more visits with my PCP, late-night trips to the ER for chest pain that you cannot ignore, and a flurry of pain meds like oxycodone and tramadol, I was finally told I had fibromyalgia. [self.com]

  Chest pain When fibromyalgia pain is in your chest, it can feel similar to the pain of a heart attack. Chest pain in fibromyalgia is centered in the cartilage that connects your ribs to your breastbone. [healthline.com]

  Fibromyalgia (FM) is a common, chronic, generalized pain syndrome of unknown origin. Although pain and tenderness are its defining features, fatigue, sleep disturbance, non-cardiac chest pain, depression and poor concentration are also common. [hopkinsarthritis.org]

• Hyperacusis

  Cell Count Increased: 3 people, 42.86% Fatigue (feeling of tiredness): 3 people, 42.86% Miosis (constriction of the pupil of the eye, resulting from a normal response to an increase in light): 3 people, 42.86% Vision - Night Blindness: 3 people, 42.86% Hyperacusis [ehealthme.com]

  Among the symptoms: Headaches Chronic migraines Dizziness and vertigo Fainting (syncope) Sensitivity to temperature, humidity, and an atmospheric pressure Sensitivity to light (photophobia) Sensitivity to noise (hyperacusis) Sensitivity to smells (hyperosmia [verywellhealth.com]

• Photophobia

  Among the symptoms: Headaches Chronic migraines Dizziness and vertigo Fainting (syncope) Sensitivity to temperature, humidity, and an atmospheric pressure Sensitivity to light (photophobia) Sensitivity to noise (hyperacusis) Sensitivity to smells (hyperosmia [verywellhealth.com]

  Pain is often unilateral, throbbing, worse with exertion, and accompanied by symptoms... read more or tension headaches Symptoms and Signs Tension-type headache causes mild generalized pain (usually viselike) without the incapacity, nausea, or photophobia [msdmanuals.com]

  […] criteria published by official bodies 37 - 40 as described previously, 35 except that our criteria for migraine used modifications for epidemiologic studies derived from Merikangas et al 41 that required (1) severe headaches and (2) the presence of both photophobia [doi.org]

• Hyperhidrosis

  Evidence of neuronal hyperexcitability (hyperhidrosis, quantitative heat-pain hyperalgesia, or electromyographic excitability) was 25-fold more common in pain patients. [neurology.org]

  18) Hot flush 5 4092 11 2 4.9 (3.4 to 6.9) 12 (10 to 14) Dizziness 5 4092 10 6 1.8 (1.4 to 2.3) 21.5 (16 to 33) Palpitations 4 3986 7.1 2.5 3.1 (2.2 to 4.3) 25 (17 to 42) Tachycardia/increased heart rate 4 3986 5.9 0.9 5.2 (3.2 to 8.6) 41 (27 to 67) Hyperhidrosis [doi.org]

• Skin Tenderness

  Illustration of 9 paired tender points identified in the 1990 statement of the American College of Rheumatology on fibromyalgia. [emedicine.com]

• Back Pain

  Fluoroquinolone toxicity symptoms in a patient presenting with low back pain. [doi.org]

  C 12, 13, 15 Skeletal muscle relaxants may be used as adjunctive therapy for acute low back pain. B 17, 18 Antispasmodic agents should be used short-term (two weeks) for acute low back pain. [aafp.org]

  A literature search was performed through PubMed and Ovid using the terms fibromyalgia, temporomandibular joint disorder, irritable bowel syndrome, irritable bladder/interstitial cystitis, headache, chronic low back pain, chronic neck pain, functional [ncbi.nlm.nih.gov]

• Restless Legs Syndrome

  Associated disorders are restless leg syndrome, irritable bowel syndrome, irritable bladder syndrome, cognitive dysfunction, cold intolerance, multiple sensitivities and dizziness. [ncbi.nlm.nih.gov]

  Dopamine agonist-induced pathological gambling in restless legs syndrome due to multiple sclerosis. Movement Disorders, 22 (4), 590–591. doi: 10.1002/mds.21303. PubMed CrossRef Google Scholar Gallagher, D. A., O’Sullivan, S. S., Evans, A. [doi.org]

  Other symptoms Other symptoms you may have if you have fibromyalgia include: dizziness and clumsiness feeling too hot or too cold – this is because you're not able to regulate your body temperature properly an overwhelming urge to move your legs (restless [nhs.uk]

  FM sufferers also experience extreme fatigue, irritable bowel and bladder, headaches and migraines, restless leg syndrome (periodic limb movement disorder), impaired memory and concentration, skin sensitivities and rashes, dry eyes and mouth, anxiety, [uclahealth.org]

• Low Back Pain

  Fluoroquinolone toxicity symptoms in a patient presenting with low back pain. [doi.org]

  C 12, 13, 15 Skeletal muscle relaxants may be used as adjunctive therapy for acute low back pain. B 17, 18 Antispasmodic agents should be used short-term (two weeks) for acute low back pain. [aafp.org]

  A literature search was performed through PubMed and Ovid using the terms fibromyalgia, temporomandibular joint disorder, irritable bowel syndrome, irritable bladder/interstitial cystitis, headache, chronic low back pain, chronic neck pain, functional [ncbi.nlm.nih.gov]

• Myalgia

  A 39-year-old woman with a 3-year history of a rounded face developed widespread myalgia. Detailed examinations revealed no disorders that could explain the pain other than concomitant Cushing's disease and central hypothyroidism. [ncbi.nlm.nih.gov]

  Lingual myositis Lumbar myofascial pain syndrome Maxillary myositis Muscle pain Muscle pain, abdominal Muscle tension pain Musculoskeletal pain Myalgia Myalgia (muscle pain) Myalgia/myositis - multiple Myalgia/myositis - shoulder Myofacial pain syndrome [icd9data.com]

  […] compartment syndrome + Congenital Myopathy with Neuropathy and Deafness Contracture + Craniomandibular Disorders + diaphragm disease + Dimauro Disease Early-Onset Myopathy with Fatal Cardiomyopathy EHLERS-DANLOS SYNDROME, KYPHOSCOLIOTIC TYPE, 2 eosinophilia-myalgia [rgd.mcw.edu]

• Neck Pain

  A literature search was performed through PubMed and Ovid using the terms fibromyalgia, temporomandibular joint disorder, irritable bowel syndrome, irritable bladder/interstitial cystitis, headache, chronic low back pain, chronic neck pain, functional [ncbi.nlm.nih.gov]

  Through therapy, massage therapists can help their clients experience improved sleep, less neck pain, better balance, a decrease in the body’s sensitivity to pain, along with an increase in mobility and flexibility. [massagemag.com]

  Symptoms of fibromyalgia Pain and fatigue are the most common symptoms of fibromyalgia. Pain. Pain and stiffness, can occur in muscles and joints almost anywhere in the body, including the trunk, neck, shoulders, back and hips. [health.harvard.edu]

  People with fibromyalgia often report additional types of pain, including headaches, back and neck pain, sore throat, pain or clicking in the jaw (temporomandibular joint dysfunction), and stomach pain or digestive disorders such as irritable bowel syndrome [ghr.nlm.nih.gov]

  Symptoms Fibromyalgia can cause pain and stiffness in the muscles and joints almost anywhere in the body, including the trunk, neck, shoulders, back and hips. People often have pain between the shoulder blades and at the bottom of the neck. [drugs.com]

• Dysmenorrhea

  Conditions commonly associated with fibromyalgia include: Depression and anxiety Chronic headache, such as tension headaches Irritable bowel syndrome (IBS) Dysmenorrhea Female urethral syndrome (irritable bladder) Copyright © Nucleus Medical Media, Inc [uvahealth.com]

  Sleep disturbance, fatigue, morning stiffness > 15 minutes, paresthesias, anxiety, headache, prior depression, irritable bowel syndrome, sicca symptoms, urinary urgency, dysmenorrhea history, and Raynaud’s phenomenon are all listed in Table 6 of the 1990 [dx.doi.org]

  […] syndrome T-T headache (tension type) Migraine Temporomandibular disorders Myofascial pain syndrome Female urethral syndrome/interstitial cystitis Multiple chemical sensitivity syndrome Restless leg syndrome Periodic limb movements in sleep (PLMS) Primary dysmenorrhea [emedicine.com]

• Headache

  The aim of this study was to determine if patients with co-morbid fibromyalgia and migraine report more depressive symptoms, have more headache related disability, or report higher intensity of headache as compared to patients with migraine only. [ncbi.nlm.nih.gov]

  Fibromyalgia headache hyperalgesia NMDA-receptor antagonist nitric oxide serotonergic analgesia © 1998 International Headache Society doi: 10.1177/0333102498018S2111 Cephalalgia February 1998 vol. 18 no. 21 suppl 41-44 [web.archive.org]

  […] at bedtime 50-200 mg Nausea, headache, dizziness, insomnia × [doi.org]

  you may also have frequent headaches. [nhs.uk]

• Irritability

  : The sense of coherence index and the irritable bowel syndrome: a cross-sectional comparison among irritable bowel syndrome patients with and without coexisting fibromyalgia, irritable bowel syndrome non-patients, and controls. [doi.org]

  Associated disorders are restless leg syndrome, irritable bowel syndrome, irritable bladder syndrome, cognitive dysfunction, cold intolerance, multiple sensitivities and dizziness. [ncbi.nlm.nih.gov]

• Sleep Disturbance

  Sleep disturbances Sleeping problems are common and you can wake up feeling tired, even after sleeping through the night. This tiredness can range from listlessness to exhaustion and can vary from one day to the next. Disturbed sleep is also common. [healthnavigator.org.nz]

  It has been suggested that sleep disturbances, which are common in fibromyalgia patients, may actually cause the condition. [web.archive.org]

  For people with fibromyalgia, the combination of pain and sleep disturbance is a double-edged sword: the pain makes sleep more difficult and sleep deprivation exacerbates pain. [sleepfoundation.org]

  Contributing authors begin to unravel the many unanswered questions about fibromyalgia as they explore the mechanisms underlying pain, fatigue, and sleep disturbance, the interrelationship between pain, fatigue, and sleep disturbance, and the relationship [books.google.es]

• Difficulty Concentrating

  A neurologist can help rule out a neurological condition separate from fibromyalgia, if you have difficulty concentrating or if you feel tingling sensations in your arms, hands, legs or feet. [hss.edu]

  Common symptoms include: Widespread pain Joint stiffness Debilitating fatigue Headaches Irritable bowel syndrome Sleep disturbance Cognitive symptoms, such as difficulty concentrating On average, Americans living with fibromyalgia endure three years of [lecomhealth.com]

  Patients may feel as though their arms and legs are weighted down by concrete blocks and their bodies may be so drained of energy that every task is an effort.7 Memory and Concentration - Difficulty concentrating and retaining new information may seriously [afsafund.org]

  About 2 percent of the U.S. population has fibromyalgia, which can cause chronic pain, fatigue, depression, sleep problems and difficulty concentrating. [wexnermedical.osu.edu]

  Other symptoms may include sleep disturbances, fatigue, general morning stiffness, headaches, difficulty concentrating and memory (cognitive disorders) difficulties, dizziness, numbness in the hands, abnormal body temperature (up to 37.5 ° C), as well [kolzchut.org.il]

• Cervical Radiculopathy

  Neurologic diseases: peripheral neuropathies, cervical radiculopathy, entrapment syndromes (e.g. carpal tunnel syndrome), multiple sclerosis, myasthenia gravis · Multiple sclerosis and myasthenia gravis are associated with post-exercise muscle and generalized [ncbi.nlm.nih.gov]

The entire diagnostic process is dependent on finding tenderness in certain areas of the body. The increased sensitivity to mild or tender pressure may be seen in different parts of the body or all over the body [7]. These are sites marked as generally fairly sensitive areas and they are also the easiest to check for the tenderness that is common with individuals suffering from fibromyalgia.

Examinations will not show any other abnormalities apart from areas of tenderness and there are no laboratory tests for confirming this condition. On the other hand, tests may be conducted in some cases so as to rule out conditions that post similar symptoms. For instance, blood tests may be used to rule oit an underactive thyroid and early cases of early arthritis.

There is no cure for fibromyalgia and treatments are often aimed at reducing symptoms as much as possible [8]. Over the years, lots of treatment types have been advocated with each one offering varying degrees of success.

Regular exercise is one form of treatment without any medications while painkillers and antidepressants form the basis of medication based treatments.

According to long term follow up studies, fibromyalgia is chronic. However, the symptoms may wax and wane. The impact of fibromyalgia on daily activities including ability to do all daily tasks varies greatly amongst patients [5]. The condition is generally as disabling as rheumatoid arthritis and there is no lid as to how long an individual will have to live with it. People with this condition face the risk of losing their jobs, possessions, etc.

The main causes of fibromyalgia remain unknown but many hypotheses have been postulated [2]. Some of the suspected causes are as follows:

• Contributory and predisposing factors (like sleep disturbance, depression and chronic illness)
• Psychological distress and a somatic manifestation of depression
• Tissue trauma such as surgery or physical injury (between 14-23% of patients develop the condition after trauma or surgery)
• Immunologic abnormalities (55% of patients developed fibromyalgia after infections with HIV, Lyme disease and coxsackievirus)
• Changes in peripheral nociceptors leading to an increased perception of pain
• Changes in muscle tissue at the cellular level in addition to changes in blood flow

The diagnosis of this condition is largely subjective and therefore incidence and numbers should only be interpreted in this context [3].

The condition is seen in 20-30 individuals per 1000. It is spread evenly amongst individuals aged 18-70 years. But it is mostly prevalent in people within the 30-50 years age bracket.
Fibromyalgia occurs mostly in females and the ration to males is 9:1.

Till date, there has not been any conclusive evidence on the impact of genetics in fibromyalgia. However, first degree relatives of fibromyalgia have been noted to show an increased incidence of depression.

Fibromyalgia is seen mostly in people within the middle and upper socioeconomic classes. However, this may be down to the fact that most individuals in the lower class will rather sit out symptoms consistent with fibromyalgia due to poor access to care and general poverty.

Fibromyalgia is generally regarded as a disorder affecting the central pain processor and a syndrome affecting central sensitivity. Patients with this condition often have a diffuse problem of sensory volume control leaving them with a lower threshold for pain and relevant stimuli like noise, heat and strong odours [4].

Due to neurobiologic changes that affect the perception of pain or because of expectancy and hypervigilance, patients may have hypersensitivity. This may be related to certain psychological factors.

Even though the pathogenesis of fibromyalgia isn’t entirely understood, research has shown some immunoregulatory, biochemical and metabolic abnormalities. This has confirmed suspicions that fibromyalgia can no longer be regarded as a subjective pain condition.

No proven methods of prevention but exercise reduces the chances of suffering from it [9] [10].

Fibromyalgia is a chronic musculoskeletal disorder. It is a condition with a pathophysiology that is poorly understood and there is very few pathognomonic findings concerning it [1].

Fibromyalgia is characterised by widespread pain with very distinct tender points and morning stiffness. There have not been any evidence of inflammatory causes and the condition is equally associated with sleep disorders, fatigue and depression.

Treatment for the condition is symptom-based, multidisciplinary and in many cases often unsatisfactory.

Fibromyalgia is a disorder that is known for the widespread pain in the skeleton and muscles that it causes. The pain is accompanied by fatigue and problems with memory, sleep and mood. 

In patients with Fibromyalgia the way the brain processes pain signals is affected amplifying any painful sensations. 

The symptoms of fibromyalgia kick in following surgery, infection, significant psychological stress and also physical trauma.  It also possible for the symptoms to  accumulate over a period of time without any known causes. 

Most people who have fibromyalgia also witness headaches, joint disorders, as well as depression and anxiety.

Presently, there is no total cure for fibromyalgia but a combination of relevant medications will help control the symptoms. Exercise, stress reduction activities as well as relaxation can also help.

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2. Yunus MB. Fibromyalgia and overlapping disorders: the unifying concept of central sensitivity syndromes. Semin Arthritis Rheum. Jun 2007;36(6):339-56.
3. Burgmer M, Pogatzki-Zahn E, Gaubitz M, et al. Altered brain activity during pain processing in fibromyalgia. Neuroimage. Jan 15 2009;44(2):502-8.
4. Gracely RH, Petzke F, Wolf JM, Clauw DJ. Functional magnetic resonance imaging evidence of augmented pain processing in fibromyalgia. Arthritis Rheum. May 2002;46(5):1333-43.
5. Wolfe F, Cathey MA, Kleinheksel SM. Fibrositis (Fibromyalgia) in rheumatoid arthritis. J Rheumatol. Dec 1984;11(6):814-8. [Medline].
6. Hassett AL, Gevirtz RN. Nonpharmacologic treatment for fibromyalgia: patient education, cognitive-behavioral therapy, relaxation techniques, and complementary and alternative medicine. Rheum Dis Clin North Am 2009; 35:393.
7. Goldenberg DL, Burckhardt C, Crofford L. Management of fibromyalgia syndrome. JAMA 2004; 292:2388.
8. Carville SF, Arendt-Nielsen S, Bliddal H, et al. EULAR evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis 2008; 67:536.
9. Boomershine CS, Crofford LJ. A symptom-based approach to pharmacologic management of fibromyalgia. Nat Rev Rheumatol 2009; 5:191.
10. Schmidt-Wilcke T, Clauw DJ. Fibromyalgia: from pathophysiology to therapy. Nat Rev Rheumatol 2011; 7:518.