Fibromyalgia syndrome varies from being a mild intermittent
disorder to one that is severe and protracted. Much of the
management of the more common milder type is best done at the
primary care level with the expectancy of improvement in key
symptoms and a generally good prognosis. Careful appraisal of
the dimensions of fibromyalgia is needed with an
individualized management strategy. Critical to good outcome
is the need for an understandable explanation of the mechanism
of fibromyalgia and introduction to self-management skills
that include exercise and techniques that minimize aberrant
responses to psychosocial stressors.
The primary care
practitioner is well placed to identify risk factors that
associate with fibromyalgia in order to minimize emotional
distress accompanying illness or psychosocial predicaments.
Little formal research has been done on these important areas.
In contrast, there is much information on management of
fibromyalgia when it presents to specialist practice. More
complex and expensive approaches result in variable changes in
the outcome of fibromyalgia.
Schachna L, Littlejohn G