Management of Fibromyalgia in Older Adults

Fibromyalgia (FM) is a pain syndrome characterized by dysregulation of pain-processing mechanisms. FM may arise de novo or evolve following nervous system sensitization after an identifiable triggering event or related to a peripheral pain generator such as osteoarthritis. Although the focus symptom of FM is generalized body pain, patients may also experience sleep and mood disturbance, fatigue, and other somatic symptoms leading to the concept of a polysymptomatic condition. In view of prevalent other comorbidities in older patients, FM may be overlooked and management may be neglected, thereby contributing to poor well-being. Pertinent to the older patient is to ensure that the diagnosis of FM is correct and that other conditions are not misdiagnosed as FM. Whereever possible, treatment strategies should emphasize non-pharmacologic interventions that encompass healthy lifestyle habits, with attention to adequate physical activity in particular. Drug treatments should be tailored to the individual needs of the patient, with knowledge that they may offer only a modest effect, but with caution to ensure that adverse effects do not overshadow therapeutic effects.