musculoskeletal and connective tissue disorders
Fibromyalgia
Key Points
Fibromyalgia-related stiffness and pain can be exacerbated by environmental or emotional stress, poor sleep, trauma, exposure to dampness or cold, or by a physician, family member, or friend who implies that the disorder is “all in the head.” Suspect fibromyalgia when generalized pain and tenderness and fatigue are unexplained, have lasted years, or are out of proportion to physical and laboratory findings. Consider checking erythrocyte sedimentation rate (ESR) or C-reactive protein, creatine kinase (CK), and tests for Diagnosis and Consider fibromyalgia in patients having apparent painful exacerbations of systemic rheumatic disorders such as Rheumatoid Arthritis (RA) or Treat by emphasizing physical methods, stress management, and sleep improvement, and, when necessary for pain, by giving nonopioid analgesics. 