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Harrison's Principles of Internal Medicine, 18e
| Part 15. Disorders of the Joints and Adjacent Tissues > Section 3. Disorders of the Joints and Adjacent Tissues > |
Chapter 335. Fibromyalgia
Sections: Fibromyalgia: Introduction, Further Readings.
Topics Discussed: fibromyalgia.
Excerpt:"Fibromyalgia (FM) is characterized by chronic widespread musculoskeletal pain and tenderness. Although it is defined primarily as a pain syndrome, FM patients also commonly complain of associated neuropsychological symptoms of fatigue, unrefreshing sleep, cognitive dysfunction, anxiety, and depression. Patients with FM have an increased prevalence of other syndromes associated with pain and fatigue, including chronic fatigue syndrome (Chap. 389), temporomandibular disorder, chronic headaches, irritable bowel syndrome, interstitial cystitis/painful bladder syndrome, and other pelvic pain syndromes. Available evidence implicates the central nervous system as key to maintaining pain and other core symptoms of FM and related conditions. The presence of FM is associated with substantial negative consequences for physical and social functioning.The most common presenting complaint of a patient with FM is "pain all over." Patients with FM have pain that is typically above and below the waist on both sides of the body and involves the axial skeleton (neck, back, or chest). The pain attributable to FM is poorly localized, difficult to ignore, severe in its intensity, and associated with a reduced functional capacity. Pain should have been present most of the day..."
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