The American Journal of Medicine
Volume 122, Issue 12, Supplement , Pages S3-S13 , December 2009

Fibromyalgia: An Overview

  • Daniel J. Clauw, MD

      Affiliations

    • Corresponding Author InformationRequests for reprints should be addressed to Daniel J. Clauw, MD, Chronic Pain & Fatigue Research Center, Division of Rheumatology, University of Michigan, 24 Frank Lloyd Wright Drive, PO Box 385, Lobby M, Ann Arbor, Michigan 48106

References 

  1. Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L. An internet survey of 2,596 people with fibromyalgia. BMC Musculoskelet Disord. 2007;8:27
  2. Hudson JI, Hudson MS, Pliner LF, Goldenberg DL, Pope HG. Fibromyalgia and major affective disorder: a controlled phenomenology and family history study. Am J Psychiatry. 1985;142:441–446
  3. Arnold LM, Hudson JI, Hess EV, et al. Family study of fibromyalgia. Arthritis Rheum. 2004;50:944–952
  4. Drossman DA. Sexual and physical abuse and gastrointestinal illness. Scand J Gastroenterol Suppl. 1995;208:90–96
  5. Aaron LA, Bradley LA, Alarcon GS, et al. Psychiatric diagnoses in patients with fibromyalgia are related to health care-seeking behavior rather than to illness. Arthritis Rheum. 1996;39:436–445
  6. Maixner W, Fillingim R, Booker D, Sigurdsson A. Sensitivity of patients with painful temporomandibular disorders to experimentally evoked pain. Pain. 1995;63:341–351
  7. Naliboff BD, Derbyshire SW, Munakata J, et al. Cerebral activation in patients with irritable bowel syndrome and control subjects during rectosigmoid stimulation. Psychosom Med. 2001;63:365–375
  8. Giesecke T, Gracely RH, Grant MA, et al. Evidence of augmented central pain processing in idiopathic chronic low back pain. Arthritis Rheum. 2004;50:613–623
  9. Giesecke J, Reed BD, Haefner HK, Giesecke T, Clauw DJ, Gracely RH. Quantitative sensory testing in vulvodynia patients and increased peripheral pressure pain sensitivity. Obstet Gynecol. 2004;104:126–133
  10. Moshiree B, Price DD, Robinson ME, Gaible R, Verne GN. Thermal and visceral hypersensitivity in irritable bowel syndrome patients with and without fibromyalgia. Clin J Pain. 2007;23:323–330
  11. Smythe HA, Moldofsky H. Two contributions to understanding of the “fibrositis” syndrome. Bull Rheum Dis. 1977;28:928–931
  12. Moldofsky H, Scarisbrick P, England R, Smythe H. Musculosketal symptoms and non-REM sleep disturbance in patients with “fibrositis syndrome” and healthy subjects. Psychosom Med. 1975;37:341–351
  13. Yunus M, Masi AT, Calabro JJ, Miller KA, Feigenbaum SL. Primary fibromyalgia (fibrositis): clinical study of 50 patients with matched normal controls. Semin Arthritis Rheum. 1981;11:151–171
  14. Wolfe F, Smythe HA, Yunus MB, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia: report of the Multicenter Criteria Committee. Arthritis Rheum. 1990;33:160–172
  15. Yunus MB. Towards a model of pathophysiology of fibromyalgia: aberrant central pain mechanisms with peripheral modulation. J Rheumatol. 1992;19:846–850
  16. Clauw DJ, Chrousos GP. Chronic pain and fatigue syndromes: overlapping clinical and neuroendocrine features and potential pathogenic mechanisms. Neuroimmunomodulation. 1997;4:134–153
  17. Wessely S, Nimnuan C, Sharpe M. Functional somatic syndromes: one or many?. Lancet. 1999;354:936–939
  18. Barsky AJ, Borus JF. Functional somatic syndromes. Ann Intern Med. 1999;130:910–921
  19. Fukuda K, Nisenbaum R, Stewart G, et al. Chronic multisymptom illness affecting Air Force veterans of the Gulf War. JAMA. 1998;280:981–988
  20. Hudson JI, Goldenberg DL, Pope HG, Keck PE, Schlesinger L. Comorbidity of fibromyalgia with medical and psychiatric disorders. Am J Med. 1993;92:363–367
  21. Clauw DJ. Fibromyalgia: update on mechanisms and management. J Clin Rheumatol. 2007;13:102–109
  22. Woolf CJ. Pain: moving from symptom control toward mechanism-specific pharmacologic management. Ann Intern Med. 2004;140:441–451
  23. Yunus MB. Central sensitivity syndromes: a new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness. Semin Arthritis Rheum. 2008;37:339–352
  24. Buskila D, Neumann L, Hazanov I, Carmi R. Familial aggregation in the fibromyalgia syndrome. Semin Arthritis Rheum. 1996;26:605–611
  25. Kato K, Sullivan PF, Evengard B, Pedersen NL. Chronic widespread pain and its comorbidities: a population-based study. Arch Intern Med. 2006;166:1649–1654
  26. Kato K, Sullivan PF, Evengard B, Pedersen NL. Importance of genetic influences on chronic widespread pain. Arthritis Rheum. 2006;54:1682–1686
  27. Bondy B, Spaeth M, Offenbaecher M, et al. The T102C polymorphism of the 5-HT2A-receptor gene in fibromyalgia. Neurobiol Dis. 1999;6:433–439
  28. Offenbaecher M, Bondy B, de Jonge S, et al. Possible association of fibromyalgia with a polymorphism in the serotonin transporter gene regulatory region. Arthritis Rheum. 1999;42:2482–2488
  29. Buskila D, Cohen H, Neumann L, Ebstein RP. An association between fibromyalgia and the dopamine D4 receptor exon III repeat polymorphism and relationship to novelty seeking personality traits. Mol Psychiatry. 2004;9:730–731
  30. Buskila D. Genetics of chronic pain states. Best Pract Res Clin Rheumatol. 2007;21:535–547
  31. Sapolsky RM. Why stress is bad for your brain. Science. 1996;273:749–750
  32. Chrousos GP, Gold PW. The concepts of stress and stress system disorders: overview of physical and behavioral homeostasis. JAMA. 1992;267:1244–1252
  33. Pillow DR, Zautra AJ, Sandler I. Major life events and minor stressors: identifying mediational links in the stress process. J Pers Soc Psychol. 1996;70:381–394
  34. Clauw DJ, Engel CC, Aronowitz R, et al. Unexplained symptoms after terrorism and war: an expert consensus statement. J Occup Environ Med. 2003;45:1040–1048
  35. Heim C, Newport DJ, Bonsall R, Miller AH, Nemeroff CB. Altered pituitary-adrenal axis responses to provocative challenge tests in adult survivors of childhood abuse. Am J Psychiatry. 2001;158:575–581
  36. McLean SA, Clauw DJ. Predicting chronic symptoms after an acute “stressor”—lessons learned from 3 medical conditions. Med Hypotheses. 2004;63:653–658
  37. Aaron LA, Bradley LA, Alarcon GS, et al. Perceived physical and emotional trauma as precipitating events in fibromyalgia: associations with health care seeking and disability status but not pain severity [see comments]. Arthritis Rheum. 1997;40:453–460
  38. Alexander RW, Bradley LA, Alarcon GS, et al. Sexual and physical abuse in women with fibromyalgia: association with outpatient health care utilization and pain medication usage. Arthritis Care Res. 1998;11:102–115
  39. Boisset-Pioro MH, Esdaile JM, Fitzcharles MA. Sexual and physical abuse in women with fibromyalgia syndrome. Arthritis Rheum. 1995;38:235–241
  40. Arguelles LM, Afari N, Buchwald DS, Clauw DJ, Furner S, Goldberg J. A twin study of posttraumatic stress disorder symptoms and chronic widespread pain. Pain. 2006;124:150–157
  41. Glass JM, Lyden A, Petzke F, Clauw D. The effect of brief exercise cessation on pain, fatigue, and mood symptom development in healthy, fit individuals. J Psychosom Res. 2004;57:391–398
  42. McBeth J, Silman AJ, Gupta A, et al. Moderation of psychosocial risk factors through dysfunction of the hypothalamic-pituitary-adrenal stress axis in the onset of chronic widespread musculoskeletal pain: findings of a population-based prospective cohort study. Arthritis Rheum. 2007;56:360–371
  43. Arnson Y, Amital D, Fostick L, et al. Physical activity protects male patients with post-traumatic stress disorder from developing severe fibromyalgia. Clin Exp Rheumatol. 2007;25:529–533
  44. Crofford LJ, Pillemer SR, Kalogeras KT, et al. Hypothalamic-pituitary-adrenal axis perturbations in patients with fibromyalgia. Arthritis Rheum. 1994;37:1583–1592
  45. Demitrack MA, Crofford LJ. Evidence for and pathophysiologic implications of hypothalamic-pituitary-adrenal axis dysregulation in fibromyalgia and chronic fatigue syndrome. Ann N Y Acad Sci. 1998;840:684–697
  46. Qiao ZG, Vaeroy H, Morkrid L. Electrodermal and microcirculatory activity in patients with fibromyalgia during baseline, acoustic stimulation and cold pressor tests. J Rheumatol. 1991;18:1383–1389
  47. Adler GK, Kinsley BT, Hurwitz S, Mossey CJ, Goldenberg DL. Reduced hypothalamic-pituitary and sympathoadrenal responses to hypoglycemia in women with fibromyalgia syndrome. Am J Med. 1999;106:534–543
  48. Martinez-Lavin M, Hermosillo AG, Rosas M, Soto ME. Circadian studies of autonomic nervous balance in patients with fibromyalgia: a heart rate variability analysis. Arthritis Rheum. 1998;41:1966–1971
  49. Cohen H, Neumann L, Shore M, Amir M, Cassuto Y, Buskila D. Autonomic dysfunction in patients with fibromyalgia: application of power spectral analysis of heart rate variability. Sem Arthritis Rheum. 2000;29:217–227
  50. Catley D, Kaell AT, Kirschbaum C, Stone AA. A naturalistic evaluation of cortisol secretion in persons with fibromyalgia and rheumatoid arthritis. Arthritis Care Res. 2000;13:51–61
  51. McLean SA, Williams DA, Stein PK, et al. Cerebrospinal fluid corticotropin-releasing factor concentration is associated with pain but not fatigue symptoms in patients with fibromyalgia. Neuropsychopharmacology. 2006;31:2776–2782
  52. Cohen H, Buskila D, Neumann L, Ebstein RP. Confirmation of an association between fibromyalgia and serotonin transporter promoter region (5- HTTLPR) polymorphism, and relationship to anxiety-related personality traits. Arthritis Rheum. 2002;46:845–847
  53. Bou-Holaigah I, Calkins H, Flynn JA, et al. Provocation of hypotension and pain during upright tilt table testing in adults with fibromyalgia. Clin Exp Rheumatol. 1997;15:239–246
  54. Naschitz JE, Rosner I, Rozenbaum M, et al. The capnography head-up tilt test for evaluation of chronic fatigue syndrome. Semin Arthritis Rheum. 2000;30:79–86
  55. McBeth J, Jones K. Epidemiology of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol. 2007;21:403–425
  56. Wolfe F, Ross K, Anderson J, Russell IJ. Aspects of fibromyalgia in the general population: sex, pain threshold, and fibromyalgia symptoms. J Rheumatol. 1995;22:151–156
  57. Wolfe F. The relation between tender points and fibromyalgia symptom variables: evidence that fibromyalgia is not a discrete disorder in the clinic. Ann Rheum Dis. 1997;56:268–271
  58. Gracely RH, Grant MA, Giesecke T. Evoked pain measures in fibromyalgia. Best Pract Res Clin Rheumatol. 2003;17:593–609
  59. Jensen K, Andersen HO, Olesen J, Lindblom U. Pressure-pain threshold in human temporal region: evaluation of a new pressure algometer. Pain. 1986;25:313–323
  60. Petzke F, Gracely RH, Park KM, Ambrose K, Clauw DJ. What do tender points measure? (nfluence of distress on 4 measures of tenderness). J Rheumatol. 2003;30:567–574
  61. Petzke F, Gracely RH, Khine A, Clauw DJ. Pain sensitivity in patients with fibromyalgia (FM): expectancy effects on pain measurements [abstract]. Arthritis Rheum. 1999;42:S342
  62. Petzke F, Khine A, Williams D, Groner K, Clauw DJ, Gracely RH. Dolorimetry performed at 3 paired tender points highly predicts overall tenderness. J Rheumatol. 2001;28:2568–2569
  63. Petzke F, Clauw DJ, Ambrose K, Khine A, Gracely RH. Increased pain sensitivity in fibromyalgia: effects of stimulus type and mode of presentation. Pain. 2003;105:403–413
  64. Harris RE, Gracely RH, McLean SA, et al. Comparison of clinical and evoked pain measures in fibromyalgia. J Pain. 2006;7:521–527
  65. Geisser ME, Gracely RH, Giesecke T, Petzke FW, Williams DA, Clauw DJ. The association between experimental and clinical pain measures among persons with fibromyalgia and chronic fatigue syndrome. Eur J Pain. 2007;11:202–207
  66. Gibson SJ, Littlejohn GO, Gorman MM, Helme RD, Granges G. Altered heat pain thresholds and cerebral event-related potentials following painful CO2 laser stimulation in subjects with fibromyalgia syndrome. Pain. 1994;58:185–193
  67. Kosek E, Hansson P. Modulatory influence on somatosensory perception from vibration and heterotopic noxious conditioning stimulation (HNCS) in fibromyalgia patients and healthy subjects. Pain. 1997;70:41–51
  68. Geisser ME, Casey KL, Brucksch CB, Ribbens CM, Appleton BB, Crofford LJ. Perception of noxious and innocuous heat stimulation among healthy women and women with fibromyalgia: association with mood, somatic focus, and catastrophizing. Pain. 2003;102:243–250
  69. Kosek E, Ekholm J, Hansson P. Sensory dysfunction in fibromyalgia patients with implications for pathogenic mechanisms. Pain. 1996;68:375–383
  70. Arroyo JF, Cohen ML. Abnormal responses to electrocutaneous stimulation in fibromyalgia. J Rheumatol. 1993;20:1925–1931
  71. Gerster JC, Hadj-Djilani A. Hearing and vestibular abnormalities in primary fibrositis syndrome. J Rheumatol. 1984;11:678–680
  72. McDermid AJ, Rollman GB, McCain GA. Generalized hypervigilance in fibromyalgia: evidence of perceptual amplification. Pain. 1996;66:133–144
  73. Lautenbacher S, Rollman GB. Possible deficiencies of pain modulation in fibromyalgia. Clin J Pain. 1997;13:189–196
  74. Leffler AS, Hansson P, Kosek E. Somatosensory perception in a remote pain-free area and function of diffuse noxious inhibitory controls (DNIC) in patients suffering from long-term trapezius myalgia. Eur J Pain. 2002;6:149–159
  75. Julien N, Goffaux P, Arsenault P, Marchand S. Widespread pain in fibromyalgia is related to a deficit of endogenous pain inhibition. Pain. 2005;114:295–302
  76. Baraniuk JN, Whalen G, Cunningham J, Clauw DJ. Cerebrospinal fluid levels of opioid peptides in fibromyalgia and chronic low back pain. BMC Musculoskelet Disord. 2004;5:48
  77. Harris RE, Clauw DJ, Scott DJ, McLean SA, Gracely RH, Zubieta JK. Decreased central μ-opioid receptor availability in fibromyalgia. J Neurosci. 2007;27:10000–10006
  78. Russell IJ, Vaeroy H, Javors M, Nyberg F. Cerebrospinal fluid biogenic amine metabolites in fibromyalgia/fibrositis syndrome and rheumatoid arthritis. Arthritis Rheum. 1992;35:550–556
  79. Yunus MB, Dailey JW, Aldag JC, Masi AT, Jobe PC. Plasma tryptophan and other amino acids in primary fibromyalgia: a controlled study. J Rheumatol. 1992;19:90–94
  80. Arnold LM, Keck PEJ, Welge JA. Antidepressant treatment of fibromyalgia: a meta-analysis and review. Psychosomatics. 2000;41:104–113
  81. Arnold LM, Lu Y, Crofford LJ, et al. A double-blind, multicenter trial comparing duloxetine with placebo in the treatment of fibromyalgia patients with or without major depressive disorder. Arthritis Rheum. 2004;50:2974–2984
  82. Arnold LM, Rosen A, Pritchett YL, et al. A randomized, double-blind, placebo-controlled trial of duloxetine in the treatment of women with fibromyalgia with or without major depressive disorder. Pain. 2005;119:5–15
  83. Russell IJ, Mease PJ, Smith TR, et al. Efficacy and safety of duloxetine for treatment of fibromyalgia in patients with or without major depressive disorder: results from a 6-month, randomized, double-blind, placebo-controlled, fixed-dose trial. Pain. 2008;136:432–444
  84. Bennett RM, Kamin M, Karim R, Rosenthal N. Tramadol and acetaminophen combination tablets in the treatment of fibromyalgia pain: a double-blind, randomized, placebo-controlled study. Am J Med. 2003;114:537–545
  85. Gendreau RM, Thorn MD, Gendreau JF, et al. The efficacy of milnacipran in patients with fibromyalgia. J Rheumatol. 2005;32:1975–1985
  86. Clauw DJ, Mease P, Palmer RH, Gendreau RM, Wang Y. Milnacipran for the treatment of fibromyalgia in adults: a 15-week, multicenter, randomized, double-blind, placebo-controlled, multiple-dose clinical trial. Clin Ther. 2008;30:1988–2004[published correction appears in Clin Ther 2009;31:446]
  87. Mease PJ, Clauw DJ, Gendreau RM, et al. The efficacy and safety of milnacipran for treatment of fibromyalgia: a randomized, double-blind, placebo-controlled trial. J Rheumatol. 2009;36:389–409[published correction appears in J Rheumatol 2009;36:661]
  88. Staud R, Vierck CJ, Cannon RL, Mauderli AP, Price DD. Abnormal sensitization and temporal summation of second pain (wind-up) in patients with fibromyalgia syndrome. Pain. 2001;91:165–175
  89. Price DD, Staud R, Robinson ME, Mauderli AP, Cannon R, Vierck CJ. Enhanced temporal summation of second pain and its central modulation in fibromyalgia patients. Pain. 2002;99:49–59
  90. Woolf CJ, Thompson SW. The induction and maintenance of central sensitization is dependent on N-methyl-d-aspartic acid receptor activation: implications for the treatment of post-injury pain hypersensitivity states. Pain. 1991;44:293–299
  91. Woolf CJ. Windup and central sensitization are not equivalent. Pain. 1996;66:105–108
  92. Xu XJ, Dalsgaard CJ, Wiesenfeld-Hallin Z. Spinal substance P and N-methyl-d-aspartate receptors are coactivated in the induction of central sensitization of the nociceptive flexor reflex. Neuroscience. 1992;51:641–648
  93. Welin M, Bragee B, Nyberg F, Kristiansson M. Elevated substance P levels are contrasted by a decrease in met-enkephalin-arg-phe levels in CSF from fibromyalgia patients [abstract]. J Musculoskel Pain. 1995;3:4
  94. Vaeroy H, Helle R, Førre O, Kåss E, Terenius L. Elevated CSF levels of substance P and high incidence of Raynaud phenomenon in patients with fibromyalgia: new features for diagnosis. Pain. 1988;32:21–26
  95. Russell IJ, Orr MD, Littman B, et al. Elevated cerebrospinal fluid levels of substance P in patients with the fibromyalgia syndrome. Arthritis Rheum. 1994;37:1593–1601
  96. Bradley LA, Alberts KR, Alarcon GS, et al. Abnormal brain regional cerebral blood flow (rCBF) and cerebrospinal fluid (CSF) levels of substance P (SP) in patients and non-patients with fibromyalgia (FM) [abstract]. Arthritis Rheum. 1996;39(suppl):S212
  97. Sarchielli P, Di Filippo M, Nardi K, Calabresi P. Sensitization, glutamate, and the link between migraine and fibromyalgia. Curr Pain Headache Rep. 2007;11:343–351
  98. Mountz JM, Bradley LA, Modell JG, et al. Fibromyalgia in women: abnormalities of regional cerebral blood flow in the thalamus and the caudate nucleus are associated with low pain threshold levels. Arthritis Rheum. 1995;38:926–938
  99. Kwiatek R, Barnden L, Tedman R, et al. Regional cerebral blood flow in fibromyalgia: single-photon-emission computed tomography evidence of reduction in the pontine tegmentum and thalami. Arthritis Rheum. 2000;43:2823–2833
  100. Guedj E, Taieb D, Cammilleri S, et al. 99mTc-ECD brain perfusion SPECT in hyperalgesic fibromyalgia. Eur J Nucl Med Mol Imaging. 2007;34:130–134
  101. Guedj E, Cammilleri S, Colavolpe C, et al. Predictive value of brain perfusion SPECT for ketamine response in hyperalgesic fibromyalgia. Eur J Nucl Med Mol Imaging. 2007;34:1274–1279
  102. Guedj E, Cammilleri S, Colavolpe C, de LC, Niboyet J, Mundler O. Follow-up of pain processing recovery after ketamine in hyperalgesic fibromyalgia patients using brain perfusion ECD-SPECT. Eur J Nucl Med Mol Imaging. 2007;34:2115–2119
  103. Guedj E, Cammilleri S, Niboyet J, et al. Clinical correlate of brain SPECT perfusion abnormalities in fibromyalgia. J Nucl Med. 2008;49:1798–1803
  104. Adiguzel O, Kaptanoglu E, Turgut B, Nacitarhan V. The possible effect of clinical recovery on regional cerebral blood flow deficits in fibromyalgia: a prospective study with semiquantitative SPECT. South Med J. 2004;97:651–655
  105. Gracely RH, Petzke F, Wolf JM, Clauw DJ. Functional magnetic resonance imaging evidence of augmented pain processing in fibromyalgia. Arthritis Rheum. 2002;46:1333–1343
  106. Cook DB, Lange G, Ciccone DS, Liu WC, Steffener J, Natelson BH. Functional imaging of pain in patients with primary fibromyalgia. J.Rheumatol. 2004;31:364–378
  107. Giesecke T, Gracely RH, Williams DA, Geisser ME, Petzke FW, Clauw DJ. The relationship between depression, clinical pain, and experimental pain in a chronic pain cohort. Arthritis Rheum. 2005;52:1577–1584
  108. Gracely RH, Geisser ME, Giesecke T, et al. Pain catastrophizing and neural responses to pain among persons with fibromyalgia. Brain. 2004;127:835–843
  109. van West D, Maes M. Neuroendocrine and immune aspects of fibromyalgia. BioDrugs. 2001;15:521–531
  110. Togo F, Natelson BH, Adler GK, et al. Plasma cytokine fluctuations over time in healthy controls and patients with fibromyalgia. Exp Biol Med (Maywood). 2009;234:232–240
  111. Wang H, Moser M, Schiltenwolf M, Buchner M. Circulating cytokine levels compared to pain in patients with fibromyalgia—a prospective longitudinal study over 6 months. J Rheumatol. 2008;35:1366–1370
  112. Gur A, Oktayoglu P. Status of immune mediators in fibromyalgia. Curr Pain Headache Rep. 2008;12:175–181
  113. Rao SG, Bennett RM. Pharmacological therapies in fibromyalgia. Best Pract Res Clin Rheumatol. 2003;17:611–627
  114. Abeles M, Solitar BM, Pillinger MH, Abeles AM. Update on fibromyalgia therapy. Am J Med. 2008;121:555–561
  115. Boissevain MD, McCain GA. Toward an integrated understanding of fibromyalgia syndrome (IMedical and pathophysiological aspects). Pain. 1991;45:227–238
  116. Epstein SA, Kay GG, Clauw DJ, et al. Psychiatric disorders in patients with fibromyalgia: a multicenter investigation. Psychosomatics. 1999;40:57–63
  117. White KP, Nielson WR, Harth M, Ostbye T, Speechley M. Does the label “fibromyalgia” alter health status, function, and health service utilization? (A prospective, within-group comparison in a community cohort of adults with chronic widespread pain). Arthritis Rheum. 2002;47:260–265
  118. Turk DC, Okifuji A, Sinclair JD, Starz TW. Pain, disability, and physical functioning in subgroups of patients with fibromyalgia. J Rheumatol. 1996;23:1255–1262
  119. Giesecke T, Williams DA, Harris RE, et al. Subgrouping of fibromyalgia patients on the basis of pressure-pain thresholds and psychological factors. Arthritis Rheum. 2003;48:2916–2922
  120. Clauw DJ. The taxonomy of chronic pain: moving toward more mechanistic classifications. In:  Wallace DJ,  Clauw DJ editor. Fibromyalgia & Other Central Pain Syndromes. Philadelphia: Lippincott Williams & Wilkins; 2005;p. 9–16
  121. Tan EM, Feltkamp TE, Smolen JS, et al. Range of antinuclear antibodies in “healthy” individuals. Arthritis Rheum. 1997;40:1601–1611
  122. Pincus T. A pragmatic approach to cost-effective use of laboratory tests and imaging procedures in patients with musculoskeletal symptoms. Primary Care. 1993;20:795–814
  123. Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994;331:69–73
  124. Buskila D, Sarzi-Puttini P. Fibromyalgia and autoimmune diseases: the pain behind autoimmunity. Isr Med Assoc J. 2008;10:77–78
  125. Clauw DJ, Katz P. The overlap between fibromyalgia and inflammatory rheumatic disease: when and why does it occur?. J Clin Rheumatol. 1995;1:335–342
  126. Goldenberg DL, Burckhardt C, Crofford L. Management of fibromyalgia syndrome. JAMA. 2004;292:2388–2395
  127. Norregaard J, Volkmann H, Danneskiold-Samsoe B. A randomized controlled trial of citalopram in the treatment of fibromyalgia. Pain. 1995;61:445–449
  128. Fishbain D. Evidence-based data on pain relief with antidepressants. Ann Med. 2000;32:305–316
  129. Adelman LC, Adelman JU, Von Seggern R, Mannix LK. Venlafaxine extended release (XR) for the prophylaxis of migraine and tension-type headache: a retrospective study in a clinical setting. Headache. 2000;40:572–580
  130. Vaishnavi SN, Nemeroff CB, Plott SJ, Rao SG, Kranzler J, Owens MJ. Milnacipran: a comparative analysis of human monoamine uptake and transporter binding affinity. Biol Psychiatry. 2004;55:320–322
  131. Wiffen P, Collins S, McQuay H, Carroll D, Jadad A, Moore A. Anticonvulsant drugs for acute and chronic pain. Cochrane Database Syst Rev. 2000;3:CD001133
  132. Crofford LJ, Rowbotham MC, Mease PJ, et al. Pregabalin for the treatment of fibromyalgia syndrome: results of a randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2005;52:1264–1273
  133. Arnold LM, Russell IJ, Diri EW, et al. A 14-week, randomized, double-blinded, placebo-controlled monotherapy trial of pregabalin in patients with fibromyalgia. J Pain. 2008;9:792–805
  134. Mease PJ, Russell IJ, Arnold LM, et al. A randomized, double-blind, placebo-controlled, phase III trial of pregabalin in the treatment of patients with fibromyalgia. J Rheumatol. 2008;35:502–514
  135. Redillas C, Solomon S. Prophylactic pharmacological treatment of chronic daily headache. Headache. 2000;40:83–102
  136. Scharf MB, Baumann M, Berkowitz DV. The effects of sodium oxybate on clinical symptoms and sleep patterns in patients with fibromyalgia. J.Rheumatol. 2003;30:1070–1074
  137. Russell IJ, Perkins AT, Michalek JE. Sodium oxybate relieves pain and improves function in fibromyalgia syndrome: a randomized, double-blind, placebo-controlled, multicenter clinical trial. Arthritis Rheum. 2009;60:299–309
  138. Holman AJ, Myers RR. A randomized, double-blind, placebo-controlled trial of pramipexole, a dopamine agonist, in patients with fibromyalgia receiving concomitant medications. Arthritis Rheum. 2005;52:2495–2505
  139. Russell J, Michalek JE, Xiao Y, Hynes W, Vertiz R, Lawrence R. Therapy with a central alpha 2-adrenergic agonist (tizanidine) decreases cerebrospinal fluid substance P, and may reduce serum hyaluronic acid as it improves the clinical symptoms of the fibromyalgia syndrome [abstract]. Arthritis Rheum. 2002;46:S614
  140. Williams DA, Cary MA, Glazer LJ, Rodriguez AM, Clauw DJ. Randomized controlled trial of CBT to improve functional status in fibromyalgia [abstract]. Arthritis Rheum. 2000;43:S210
  141. Littlejohn G. The fibromyalgia syndrome: outcome is good with minimal intervention [letter]. BMJ. 1995;310:1406
  142. Macfarlane GJ, Thomas E, Papageorgiou AC, Schollum J, Croft PR, Silman AJ. The natural history of chronic pain in the community: a better prognosis than in the clinic?. J Rheumatol. 1996;23:1617–1620
  143. Wolfe F, Anderson J, Harkness D, et al. Work and disability status of persons with fibromyalgia. J Rheumatol. 1997;24:1171–1178

 Statement of author disclosure: Please see the Author Disclosures section at the end of this article.

PII: S0002-9343(09)00823-7

doi: 10.1016/j.amjmed.2009.09.006

The American Journal of Medicine
Volume 122, Issue 12, Supplement , Pages S3-S13 , December 2009