A practical approach to fibromyalgia
J Am Osteopath Assoc 2001 Apr;101(4 Suppl Pt 2):S12-7
A practical approach to fibromyalgia.
Brecher LS, Cymet TC.
The term fibromyalgia refers to a collection of symptoms with no clear
physiologic cause, but the symptoms together constitute a clearly recognizable
and distinct pathologic entity. The diagnosis is made through the examiner's
clinical observations.
The differential diagnosis must include other somatic
syndromes as well as disease entities, including hepatitis, hypothyroidism,
diabetes mellitus, electrolyte imbalance, multiple sclerosis, and cancer.
Diagnostic criteria serve as guidelines for diagnosis, not as absolute
requirements.
Treatment of fibromyalgia, which is an ongoing process, remains
individualized, relying on a good physician-patient relationship. It is
goal-oriented, directed at helping patients get restorative sleep, alleviating
the somatic pains, keeping patients productive, and regulating schedules.
It can be achieved through a goal-oriented agreement between patient and provider.
Because fibromyalgia is chronic and may affect all areas of an individual's
functioning, the physician needs to also evaluate the social support systems of
patients with fibromyalgia. The approach to treatment should integrate patient
education as well as non-pharmacologic and pharmacologic modalities.
To keep patients well educated and involved in their healthcare, physicians should
provide patients with adequate sources for reliable information.
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