Objective To validate a self-report fibromyalgia screener in a chronic pain population. Design Adults with chronic pain were evaluated with a 6-item, self-report fibromyalgia screening tool, based on revised American College of Rheumatology (ACR) fibromyalgia diagnostic criteria, with fibromyalgia diagnosed when patients experienced chronic pain and scored ≥13 on the ACR Fibromyalgia Symptom severity scale. Patients were independently assigned clinical diagnoses by treating clinicians. Setting University-based, tertiary care pain clinic Subjects 337 mixed chronic pain patients Results Agreement between the clinical diagnosis and screener diagnosis was good (P<0.001), with 76% sensitivity and 82% specificity. Conclusion A self-administered, brief fibromyalgia screening questionnaire can effectively identify chronic pain patients who will likely have clinical fibromyalgia.

Milnacipran provides modest fibromyalgia pain relief and is best used as part of a multidisciplinary treatment approach. While milnacipran was not studied in fibromyalgia patients with major depression, it may be a wise choice for fibromyalgia patients with depressive symptoms and patients for whom sedation, dizziness, edema or weight gain with gabapentin and pregabalin is a problem. Milnacipran has been found to be beneficial for treating some troublesome fibromyalgia-associated symptoms, including fatigue and cognitive dysfunction.