Fibromyalgia / Edition 1

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Overview


Characterized by chronic widespread pain, fibromyalgia presents complex problems in both its diagnosis and treatment. Fibromyalgia is a fairly common condition, affecting 2-4% of the population. The condition's prevalence has increased dramatically since 1990. The condition is not new, but has been known by various names, such as fibrositis and myofascial pain syndrome until 1990, when the American College of Rheumatology (ACR) published new classification criteria and first used the name fibromyalgia. The absence of objective diagnostic testing and the overlap with other condition often leads to a significant delay in diagnosis. There is a general misconception that the condition is unresponsive to treatment. However, published research shows that diagnosing and managing fibromyalgia leads to meaningful improvement in the patient's symptons and quality of life.

Patients with fibromyalgia often demonstrate symptons additional to pain and are consquently diagnosed with one or more co-occurring syndromes and conditions, complicating diagnosis and treatment. The comorbidities most commonly associated wtih fibromyalgia are sleep disturbance, depression, anxiety, and other psychiatric disorders. Another condition frequently demonstrated by fibromylgia patients is irritable bowel syndrome. Chronic fatigue syndrome also commonly co-occurs, and is often confused wtih fibromyalgia upon initial diagnosis. Numerous pharmacological therapy options exist to treat pain and related symptons of fibromyalgia. Achievement of desired treatment outcomes requires careful patient selection, drug administration and monitoring. Accurate diagnosis of chronic pain syndromes is critical, as some commonly used medications to treat many pain conditions are relatively ineffective wtih fibromyalgia.

Despite increasing recognition as a relatively common cause of chronic pain, fibromyalgia continues to generate controversy among clinicians. Given the intricate and challenging nature of treating fibromyalgia and comorbid disorders, it is imperative to educate primary care providers on the initial symptons, complications, and treatment strategies for fibromyalgia, as most patients with the condition will see a primary care provider for initial diagnosis/referral, and follow-up-care. In the years since the release of the ACR criteria, increasing recognition and advances in research have provided key insights into the etiology of fibromyalgia, resulting in the use of several successful pharmacological, as well as non-pharmacological, treatment approaches. However, despite the efforts of professional medical organizations and patient care groups, awareness of the current state of clinical assessment and treatment of fibromyalgia by healthcare professionals continues to be lacking.

This book is designed to provide a succint and practical guide to help primary care physicians, internists, specialists, and allied health professionals effectively diagnose and manage patients with fibromyalgia. This concise volume will provide an essential understanding of the pathophysiology of the pain, subtypes, and pitfalls in the diagnosis of this chronic condition.

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Editorial Reviews

Doody's Review Service
Reviewer: Chris Phillips, MD (Washington University Medical Center)
Description: This is a comprehensive yet concise overview of clinically relevant issues in the diagnosis of fibromyalgia.
Purpose: The purpose appears to be to provide a clinically relevant overview of this important subject. This is a reasonable goal, and the authors succeed in presenting clinically useful information to guide the diagnosis and treatment of patients with this disease.
Audience: Physicians in practice, both fellows and attendings, appear to be the intended audience, and the book is appropriate for this level of training. The first author is one of the world authorities on the subject.
Features: The book covers the history of the disease, its clinical manifestations, and pertinent diagnostic steps, as well as medical and nonmedical therapeutic considerations. Each of these areas is covered in a level of detail which exceeds most practitioners' pre-existing knowledge base, yet without being overwhelming or losing clinical relevance.
Assessment: This is a high quality and useful reference for this field. Like many books of this genre, the therapeutic recommendations and bibliography risk becoming out of date quickly, but it is current at the time of publication
From The Critics
Reviewer:Chris Phillips, MD(Washington University Medical Center)
Description:This is a comprehensive yet concise overview of clinically relevant issues in the diagnosis of fibromyalgia.
Purpose:The purpose appears to be to provide a clinically relevant overview of this important subject. This is a reasonable goal, and the authors succeed in presenting clinically useful information to guide the diagnosis and treatment of patients with this disease.
Audience:Physicians in practice, both fellows and attendings, appear to be the intended audience, and the book is appropriate for this level of training. The first author is one of the world authorities on the subject.
Features:The book covers the history of the disease, its clinical manifestations, and pertinent diagnostic steps, as well as medical and nonmedical therapeutic considerations. Each of these areas is covered in a level of detail which exceeds most practitioners' pre-existing knowledge base, yet without being overwhelming or losing clinical relevance.
Assessment:This is a high quality and useful reference for this field. Like many books of this genre, the therapeutic recommendations and bibliography risk becoming out of date quickly, but it is current at the time of publication
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Product Details

  • ISBN-13: 9780195384413
  • Publisher: Oxford University Press, USA
  • Publication date: 4/26/2010
  • Series: Oxford American Respiratory Library Series
  • Edition number: 1
  • Pages: 112
  • Product dimensions: 4.90 (w) x 7.90 (h) x 0.30 (d)

Meet the Author

Daniel J. Clauw, MD, is the Assistant Dean for Clinical and Translational Research, Professor of Internal Medicine and Director of the Chronic Pain and Fatigue Center at the University of Michigan Center for the Advancement of Clinical Research.

Daniel Wallace is a clinical professor of Medicine at the David Geffen School of Medicine at UCLA.

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Table of Contents

1 History of fibromyalgia 1

2 Definitions and classification 7

3 Epidemiology 13

4 Etiology and pathogenesis 19

5 Clinical findings---symptoms and signs 31

6 Laboratory and imaging correlates 41

7 Clinical associations and subsets 43

8 Differential diagnosis 51

9 Methods of clinical assessment and ascertainment 55

10 General concepts of treatment 57

11 Specific pharmacological and procedural approaches 65

12 Economic impact and disability issues 77

13 Prognosis 81

14 Experimental and innovative therapies 83

Appendix 1 Resource information 85

Appendix 2 Glossary 87

Index 97

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