The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

Diagnosis and Treatment of Fibromyalgia Syndrome

섬유근통 증후군의 진단과 치료

  • Lee, Shin-Seok (Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School)
  • 이신석 (전남대학교 의과대학 내과학교실)
  • Published : 2013.05.01
⟨ Previous Next ⟩

Abstract

Fibromyalgia syndrome (FMS) is characterized by chronic widespread pain and various accompanying symptoms including fatigue, sleep disturbances, and cognitive dysfunction. While the etiology of fibromyalgia is unclear, accumulating data suggest that disordered central pain processing likely plays a role in the pathogenesis of symptoms. Although the 1990 American College of Rheumatology (ACR) classification criteria for FMS were originally developed for research purposes and were not intended for clinical diagnosis, the criteria have become the de facto diagnostic criteria in clinical settings. Recently, an improved clinical case definition for FMS was proposed by ACR in 2010 to overcome several limitations of 1990 ACR criteria. Further studies are needed to assess the acceptance, reliability, and validity of the new criteria in epidemiologic and clinical studies. Many randomized controlled trials and meta-analyses confirm the therapeutic efficacy of pregabalin, duloxetine, and milnacipran, in the treatment of FMS. In view of the currently available evidence, a combination of pregabalin, duloxetine, or milnacipran as pharmacological interventions and aerobic exercise or CBT as non-pharmacological interventions seems most promising.

Keywords

References

  1. McBeth J, Jones K. Epidemiology of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol 2007;21:403-425.
  2. Wolfe F, Smythe HA, Yunus MB, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the Multicenter Criteria Committee. Arthritis Rheum 1990;33:160-172. https://doi.org/10.1002/art.1780330203
  3. Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 1995;38:19-28. https://doi.org/10.1002/art.1780380104
  4. Doherty M, Jones A. ABC of rheumatology: fibromyalgia syndrome. BMJ 1995;310:386-389. https://doi.org/10.1136/bmj.310.6976.386
  5. Buskila D, Cohen H. Comorbidity of fibromyalgia and psychiatric disorders. Curr Pain Headache Rep 2007;11:333-338. https://doi.org/10.1007/s11916-007-0214-4
  6. Ablin JN, Cohen H, Buskila D. Mechanisms of Disease: genetics of fibromyalgia. Nat Clin Pract Rheumatol 2006;2: 671-678. https://doi.org/10.1038/ncprheum0349
  7. Abeles AM, Pillinger MH, Solitar BM, Abeles M. Narrative review: the pathophysiology of fibromyalgia. Ann Intern Med 2007;146:726-734. https://doi.org/10.7326/0003-4819-146-10-200705150-00006
  8. White KP, Nielson WR, Harth M, Ostbye T, Speechley M. Does the label "fibromyalgia" alter health status, function, and health service utilization? aprospective, within-group comparison in a community cohort of adults with chronic widespread pain. Arthritis Rheum 2002;47:260-265. https://doi.org/10.1002/art.10400
  9. Annemans L, Wessely S, Spaepen E, et al. Health economic consequences related to the diagnosis of fibromyalgia syndrome. Arthritis Rheum 2008;58:895-902. https://doi.org/10.1002/art.23265
  10. Kim SK, Kim SH, Lee CK, et al. Effect of fibromyalgia syndrome on the health-related quality of life and economic burden in Korea. Rheumatology (Oxford) 2012 52:311-320.
  11. Fitzcharles MA, Boulos P. Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Rheumatology (Oxford) 2003;42:263-267. https://doi.org/10.1093/rheumatology/keg075
  12. Clauw DJ, Crofford LJ. Chronic widespread pain and fibromyalgia: what we know, and what we need to know. Best Pract Res Clin Rheumatol 2003;17:685-701. https://doi.org/10.1016/S1521-6942(03)00035-4
  13. Wolfe F, Clauw DJ, Fitzcharles MA, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken) 2010;62:600-610. https://doi.org/10.1002/acr.20140
  14. Wolfe F. How to use the new American College of Rheumatology fibromyalgia diagnostic criteria. Arthritis Care Res (Hoboken) 2011;63:1073-1074. https://doi.org/10.1002/acr.20468
  15. Vanderschueren S, Van Wambeke P, Morlion B. Fibromyalgia: do not give up the tender point count too easily: comment on the article by Wolfe et al. Arthritis Care Res (Hoboken) 2010;62:1675.
  16. Thompson EN. Diagnostic criteria for fibromyalgia: comment on the article by Wolfe et al. Arthritis Care Res (Hoboken) 2010;62:1674-1675. https://doi.org/10.1002/acr.20292
  17. Wolfe F, Ross K, Anderson J, Russell IJ. Aspects of fibromyalgia in the general population: sex, pain threshold, and fibromyalgia symptoms. J Rheumatol 1995;22:151-156.
  18. Yunus MB, Inanici F, Aldag JC, Mangold RF. Fibromyalgia in men: comparison of clinical features with women. J Rheumatol 2000;27:485-490.
  19. Toda K. Preliminary diagnostic criteria for fibromyalgia should be partially revised: comment on the article by Wolfe et al.Arthritis Care Res (Hoboken) 2011;63:308-309.
  20. Smythe HA. Unhelpful criteria sets for "diagnosis" and "assessment of severity" of fibromyalgia. J Rheumatol 2011; 38:975-978. https://doi.org/10.3899/jrheum.110142
  21. Rao SG, Gendreau JF, Kranzler JD. Understanding the fibromyalgia syndrome. Psychopharmacol Bull 2007;40:24-67.
  22. Anderberg UM, Marteinsdottir I, von Knorring L. Citalopram in patients with fibromyalgia: a randomized, double-blind, placebo-controlled study. Eur J Pain 2000;4:27-35. https://doi.org/10.1053/eujp.1999.0148
  23. Norregaard J, Volkmann H, Danneskiold-Samsoe B. A randomized controlled trial of citalopram in the treatment of fibromyalgia. Pain 1995;61:445-449. https://doi.org/10.1016/0304-3959(94)00218-4
  24. Patkar AA, Masand PS, Krulewicz S, et al. A randomized, controlled, trial of controlled release paroxetine in fibromyalgia. Am J Med 2007;120:448-454. https://doi.org/10.1016/j.amjmed.2006.06.006
  25. Arnold LM, Hess EV, Hudson JI, Welge JA, Berno SE, Keck PE Jr. A randomized, placebo-controlled, double-blind, flexible- dose study of fluoxetine in the treatment of women with fibromyalgia. Am J Med 2002;112:191-197. https://doi.org/10.1016/S0002-9343(01)01089-0
  26. Goldenberg D, Mayskiy M, Mossey C, Ruthazer R, Schmid C. A randomized, double-blind crossover trial of fluoxetine and amitriptyline in the treatment of fibromyalgia. Arthritis Rheum 1996;39:1852-1859. https://doi.org/10.1002/art.1780391111
  27. Arnold LM, Lu Y, Crofford LJ, et al. A double-blind, multicenter trial comparing duloxetine with placebo in the treatment of fibromyalgia patients with or without major depressive disorder. Arthritis Rheum 2004;50:2974-2984. https://doi.org/10.1002/art.20485
  28. Russell IJ, Mease PJ, Smith TR, et al. Efficacy and safety of duloxetine for treatment of fibromyalgia in patients with or without major depressive disorder: Results from a 6-month, randomized, double-blind, placebo-controlled, fixed-dose trial. Pain 2008;136:432-444. https://doi.org/10.1016/j.pain.2008.02.024
  29. Vitton O, Gendreau M, Gendreau J, Kranzler J, Rao SG. A double-blind placebo-controlled trial of milnacipran in the treatment of fibromyalgia. Hum Psychopharmacol 2004; 19(Suppl 1):S27-35. https://doi.org/10.1002/hup.622
  30. Clauw DJ, Mease P, Palmer RH, Gendreau RM, Wang Y. Milnacipran for the treatment of fibromyalgia in adults: a 15-week, multicenter, randomized, double-blind, placebocontrolled, multiple-dose clinical trial. Clin Ther 2008; 30:1988-2004. https://doi.org/10.1016/j.clinthera.2008.11.009
  31. Mease PJ, Clauw DJ, Gendreau RM, et al. The efficacy and safety of milnacipran for treatment of fibromyalgia. a randomized, double-blind, placebo-controlled trial. J Rheumatol 2009;36:398-409. https://doi.org/10.3899/jrheum.080734
  32. Crofford LJ, Rowbotham MC, Mease PJ, et al. Pregabalin for the treatment of fibromyalgia syndrome: results of a randomized, double-blind, placebo-controlled trial. Arthritis Rheum 2005;52:1264-1273. https://doi.org/10.1002/art.20983
  33. Arnold LM, Russell IJ, Diri EW, et al. A 14-week, randomized, double-blinded, placebo-controlled monotherapy trial of pregabalin in patients with fibromyalgia. J Pain 2008;9: 792-805. https://doi.org/10.1016/j.jpain.2008.03.013
  34. Crofford LJ, Mease PJ, Simpson SL, et al. Fibromyalgia relapse evaluation and efficacy for durability of meaningful relief (FREEDOM): a 6-month, double-blind, placebo-controlled trial with pregabalin. Pain 2008;136:419-431. https://doi.org/10.1016/j.pain.2008.02.027
  35. Mease PJ, Russell IJ, Arnold LM, et al. A randomized, double- blind, placebo-controlled, phase III trial of pregabalin in the treatment of patients with fibromyalgia. J Rheumatol 2008;35:502-514.
  36. Russell IJ, Kamin M, Bennett RM, Schnitzer TJ, Green JA, Katz WA. Efficacy of tramadol in treatment of pain in fibromyalgia. J Clin Rheumatol 2000;6:250-257. https://doi.org/10.1097/00124743-200010000-00003
  37. Bennett RM, Kamin M, Karim R, Rosenthal N. Tramadol and acetaminophen combination tablets in the treatment of fibromyalgia pain: a double-blind, randomized, placebo-controlled study. Am J Med 2003;114:537-545. https://doi.org/10.1016/S0002-9343(03)00116-5
  38. Hauser W, Klose P, Langhorst J, et al. Efficacy of different types of aerobic exercise in fibromyalgia syndrome: a systematic review and meta-analysis of randomised controlled trials. Arthritis Res Ther 2010;12:R79. https://doi.org/10.1186/ar3002
  39. Bernardy K, Füber N, Köllner V, Hauser W. Efficacy of cognitive- behavioral therapies in fibromyalgia syndrome - a systematic review and metaanalysis of randomized controlled trials. J Rheumatol 2010;37:1991-2005. https://doi.org/10.3899/jrheum.100104
  40. Terry R, Perry R, Ernst E. An overview of systematic reviews of complementary and alternative medicine for fibromyalgia. Clin Rheumatol 2012;31:55-66. https://doi.org/10.1007/s10067-011-1783-5

Cited by

  1. The Role of Central Sensitization in Chronic Pain of Rheumatic Diseases vol.34, pp.2, 2013, https://doi.org/10.7599/hmr.2014.34.2.81
  2. The Effect of Graston Technique and Chuna manual therapy combined with Korean Medical Treatment for fibromyalgia: A Case Report vol.34, pp.3, 2017, https://doi.org/10.13045/acupunct.2017098
  3. 근골격계 질환에서 진단의학검사의 활용 vol.13, pp.2, 2018, https://doi.org/10.30581/jkcmm.2018.13.2.109
  4. 섬유근통 증후군에 대한 치험 2례 vol.37, pp.1, 2020, https://doi.org/10.14406/acu.2020.032a
  5. 노인 우울증 환자에서 선택적 세로토닌 재흡수 억제제, 세로토닌 노르에피네프린 재흡수 억제제가 우울증상, 통증 그리고 신체증상에 미치는 효과 비교 vol.28, pp.1, 2013, https://doi.org/10.22722/kjpm.2020.28.1.72
  6. 두통, 현훈을 동반한 섬유근통 태음인 환자 치험 1례 vol.32, pp.4, 2013, https://doi.org/10.7730/jscm.2020.32.4.129
  7. 소화기증상을 동반한 섬유근육통 환자에 대한 오두탕 치험 1례 vol.42, pp.5, 2013, https://doi.org/10.22246/jikm.2021.42.5.863