Fibromyalgia (FM): a clinical challenge

The syndrome of fibromyalgia includes an unusually large and

heterogeneous number of symptoms apart from the core features

of generalized pain and widespread tenderness. Widespread

tenderness is the only objective criterion. There is no

evidence that fibromyalgia is a disease of the muscles or a

rheumatic syndrome. The experience from an Australian epidemic

of fibromyalgia indicates that there is an important

psychosomatic component in the pathogenesis. Probably,

fibromyalgia is not a disease entity; rather, the symptoms

reflect difficulties in coping with various types of

environmental stress. Secondary to this, sleep disturbances,

fatigue, a low level of physical activity and poor physical

fitness may develop, rendering the patients susceptible to

muscle pain and tenderness elicited by sleep disturbances. A

vicious circle may be responsible for the chronicity of the

syndrome. Identification of environmental factors and early

intervention should be given a high priority.

Lorenzen I

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