Management strategies for fibromyalgia

Clinical question: What are the effective, evidence-based strategies available for the management of fibromyalgia? Conclusion: There are a number of management strategies available with robust evidence to support their use in clinical practice. Definition: Fibromyalgia is a complex pain syndrome characterized by widespread, chronic muscular pain and tenderness, disordered sleep, emotional distress, cognitive disturbance, and fatigue. Its prevalence is estimated to be 3%-5% in the population and higher yet in patients with comorbid rheumatic diseases. Level of evidence: Systematic reviews, meta-analyses, randomized controlled trials (RCTs). Search sources: PubMed, Cochrane Library, manual search Consumer summary: Key messages for patients and clinicians are: 1. There are many effective pharmacological management strategies available for fibromyalgia. 2. A nonpharmacological, multicomponent approach utilizing education, aerobic exercise, psychological therapy, and other strategies is also effective for fibromyalgia. 3. Despite the significant and, at times, disabling physical and psychological symptoms, fibromyalgia can be a manageable condition with a potentially good outcome.