Rahman, A;
(2022)
Chronic widespread pain and the fibromyalgia syndrome.
Medicine
, 50
(3)
pp. 184-188.
10.1016/j.mpmed.2021.12.009.
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Abstract
Chronic pain syndromes are characterized by pain that is present every day and is not explicable by any specific physical injury or disease. The pain is related to central sensitization of the central nervous system pain mechanisms such that pain is amplified. The term ‘chronic widespread pain’ (CWP) means that the pain is present on both sides of the body, both above and below the waist and in the spinal region. Fibromyalgia is a subgroup of CWP in which, as well as pain, patients suffer from typical symptoms including fatigue, unrefreshing sleep and ‘fibro-fog’. It is estimated that 11% of the population suffer from CWP and 2–6% have fibromyalgia. CWP and fibromyalgia are clinical diagnoses based primarily on the history. Investigations are only useful to exclude other diagnoses or to look at specific areas where the pain is out of proportion to the rest of the body. There is no cure for CWP or fibromyalgia, and treatments are designed to improve quality of life rather than remove the symptoms. Patient education and encouragement of exercise are key. There is only weak evidence for any medications. However, amitriptyline, tramadol, duloxetine and pregabalin are all useful in some patients.
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