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Fibromyalgia: recent concepts and treatments

International Physical Medicine & Rehabilitation Journal
Maria Teresa RJ Jacob,1 Beatriz J Jacob Milani2

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Fibromyalgia is a chronic pain syndrome characterized by widespread pain often accompanied by symptoms that compromise quality of life, such as fatigue, sleep disorders, cognitive dysfunction, mood disorders. The pathology affects millions of people around the world and is still often overlooked and misunderstood. Although its pathophysiology is not fully understood, it is believed that Central Sensitization plays a preponderant role in the genesis of the disease. In addition, several studies demonstrate genetic polymorphisms in genes related to pain syndromes, pain thresholds, psychological disorders, and others pathologies frequently associated with Fibromyalgia. Different diagnostics criteria have been proposed to define the disease, however, the 2010 ACR criteria revised in 2016 is considered the most suitable. Functional imaging exams were of great importance in determining the pathophysiological mechanisms and so, the therapeutic options. A variety of randomized controlled studies and systematic reviews demonstrated the therapeutic efficacy of pharmacological and non-pharmacological approach for Fibromyalgia. This article aims to provide a current view of Fibromyalgia concepts, from possible pathophysiological mechanisms to pharmacological and non-pharmacological therapeutics.  


fibromyalgia, central sensitization, nociplastic pain, serotonin–norepinephrine reuptake inhibitors, gabapentinoid, endocannabinoid system, cannabinoids