Diagnostic Challenges and Management of Fibromyalgia

Abstract

The World Health Organization regards chronic pain to be a public health concern. In clinical medicine, fibromyalgia (FM) is the most prevalent chronic widespread pain disease. In terms of impairment, consumption of health and social resources, and impact on primary and speciality care systems, it has reached worrisome proportions. This disease is frequently managed by primary care providers. Because of its intricacy, fibromyalgia diagnosis and treatment can be difficult.Fibromyalgia is a controversial condition. It might appear ill-defined in comparison to other pain conditions, with no clear knowledge of pathophysiology and hence no particular targeted therapy. This invariably sparks debates and challenges. There is no obvious cut-off point that distinguishes FM from non-FM. The diagnosis of fibromyalgia has been complicated by several factors, including patients' healthseeking behaviour, symptom identification, and physician labelling of the disease.Fibromyalgia is currently considered a centralized pain condition, according to research that has improved our understanding of its etiopathology. A multidisciplinary strategy combining pharmacological and nonpharmacological therapies based on a biopsychosocial paradigm can result in effective therapy. Cultural and psychosocial variables appear to be a recent development in fibromyalgia, and they appear to have a larger influence on physician diagnosis than severe symptom levels in FM patients. Although physicians rely on FM criteria as the only way to classify FM patients in research and clinical settings, some crucial elements of the diagnostic challenge of fibromyalgia remain unsolved -invalidation, psychosocial variables, and diverse illness manifestation are some examples.Beyond the existing constructional scores, physicians' judgment gained in real communicative contexts with patients, appears to be the only dependable route for a more accurate diagnosis for fibromyalgia. We have performed an exhaustive review of the literature using the keywords "Fibromyalgia", "challenges" and "diagnosis" in PubMed and Google Scholar indexes up to September 2021. This article aims to examine the causes, diagnosis, and current treatment protocols of FM, as well as discuss some continuing debates and diagnostic challenges which physicians face in accurately diagnosing fibromyalgia.

Exploring the Relationship between Fibromyalgia-Related Fatigue, Physical Activity, and Quality of Life

“…The studies developed by Gracely et al [10] and Jensen et al [11] verified, through imaging exams, that FM patients have a different brain function compared to healthy individuals. These FM patients have a higher activation and mild brain distortion in areas of pain control [10][11][12]. Furthermore, the study conducted by Lutz et al [13] demonstrated that patients with FM have less gray matter in brain areas that regulate pain signals.…”

“…Due to this complexity, many patients have difficulties in describing their complaints and symptoms and, sometimes, health professionals do not identify the patient's chronic pain as fibromyalgia-related pain or still do not believe in this condition reported by patients [12]. By itself, the diagnosis is complex, due to a lack of consistent assessment tools and means to accurately diagnose FM [14].…”

Role of Etanercept and Infliximab on Nociceptive Changes Induced by the Experimental Model of Fibromyalgia

“…Fibromyalgia is a clinical syndrome characterized by chronic, widespread pain, depression, and fatigue [ 1 , 2 ]. It affects approximately the 2–5.8% of people worldwide [ 3 , 4 , 5 ].…”

Effect of vitamin B6 on pain, disease severity, and psychological profile of fibromyalgia patients; a randomized, double-blinded clinical trial

“…Fibromyalgia (FM) has been characterized by widespread chronic pain, fatigue, sleep disturbances, cognitive dysfunction, and polysymptomatic complaints [1]. It is a common and debilitating chronic nociplastic pain Open Access *Correspondence: faezegharibpoor@gmail.com disorder representing significant diagnostic and therapeutic challenges.…”