A 45-year-old man presenting with widespread chronic pain
Fibromyalgia is a chronic pain disorder characterized by widespread musculoskeletal pain for which an alternative cause cannot be identified. Its prevalence is between 2% and 7%, with women affected at a ratio of 9 to 1 relative to men. Fibromyalgia has a profound impact on quality of life, imposes a substantial economic burden, and is associated with comorbidities and increased mortality.

Fibromyalgia is underdiagnosed and undertreated, and many clinicians doubt or deny that it is a valid clinical entity, diminishing their ability to diagnose and treat patients with the condition. Recent pathophysiologic research has supported the validity of fibromyalgia as a disorder, but the data have not been disseminated sufficiently to affect clinical practice widely.

In addition, assessment of fibromyalgia is challenging, with comorbidities common and no gold standard for diagnosis. Available treatment guidelines are inconsistent and outdated; currently approved medications are relatively new, and other treatments are emerging.

Upon completion of this interactive case, participants should be able to:
• Explain the evidence for fibromyalgia as a legitimate medical disorder;
• Describe the pathophysiologic mechanisms of fibromyalgia;
• Identify optimal assessment practices for diagnosing fibromyalgia and its comorbidities;
• Formulate a treatment plan for fibromyalgia and its comorbidities that is tailored to individual patients and informed by current and emerging therapies.

» Go to this activity

Fibromyalgia concomitant with rheumatoid arthritis
The primary care clinician is emerging as the key individual to manage patients with fibromyalgia. While diagnostic accuracy and treatment regimens are being chosen with increasing accuracy, gaps in performance are still prevalent. Inappropriate diagnosis of fibromyalgia occurs in approximately 30% of all patients managed by primary care clinicians and up to 65% of patients are prescribed medications with little or no evidence supporting their efficacy in ameliorating fibromyalgia-related symptoms. It is important that clinicians receive a better grounding in important clues to help them diagnose fibromyalgia with more accuracy and treat patients — both with pharmacologic and nonpharmacologic agents — more effectively.

Upon completion of this interactive case involving the visit of a female patient diagnosed five years ago with rheumatoid arthritis (RA), participants should be able to:
• Discuss details of current approaches used to diagnose fibromyalgia;
• Integrate recent evidence supporting the use of specific pharmacologic agents in the treatment of fibromyalgia to improve patient outcomes;
• Incorporate the most appropriate nonpharmacologic interventions for the treatment of patients with fibromyalgia to further improve individualized treatment plans.

» Go to this activity

You are subscribed to ModernMedicine.com. To unsubscribe, click here

To ensure delivery to your Inbox, please add us to your address book. If you need help doing this, click here.

Advanstar Communications provides certain customer contact data (such as customers' names, addresses, phone numbers and e-mail addresses) to third parties who wish to promote relevant products, services and other opportunities which may be of interest to you. If you do not want Advanstar Communications to make your contact information available to third parties for marketing purposes, simply call (toll free) 1-866-529-2922 at any time, or fax us at 1-218-740-6417. Outside the U.S., please phone 1-218-740-6395. Contact us by mail at Advanstar Communications Inc., 131 West First St., Duluth, MN 55802-2065, USA.