Mechanisms and Evaluation | Pharmacotherapy | Nonpharmacological Treatment
Fibromyalgia is one of the most common musculoskeletal disorders
seen in rheumatology practice as well as primary care. It is often
classified among the functional somatic syndromes (FSSs), which
include irritable bowel syndrome, chronic fatigue syndrome, temporomandibular joint
disorder, interstitial cystitis, and other symptom-based conditions
manifested by a cluster of symptoms for which the pathophysiological
mechanism is not well understood (Aaron and Buchwald 2001).
Patients with one FSS often suffer from one or more other FSSs as
well as psychological comorbidity, including depression, anxiety, and
histories of abuse during childhood or as adults. The distinction
between FSS and somatoform disorders is also being revisited (Kroenke et al. 2007). However, it does not appear that FSSs are entirely
explained by psychological factors (Henningsen et al. 2003),
and emerging research also shows biological factors that may be
causative or contributory.