Fibromyalgia: Diagnosis and Treatment

Diagnosis

There are no tests for fibromyalgia. The diagnosis is based on history and physical examination, particularly the identification of specific tender points throughout the body.

In some cases, blood tests may be used to rule out other disease, such as rheumatoid arthritis, thyroid disease, and Lyme disease.

Treatment

The optimal treatment is a multidisciplinary approach, which includes exercise, physical therapy, good sleep hygiene, and mental health specialists.

• Low–impact aerobic exercise has been shown to be effective at decreasing symptoms. Muscle strengthening and flexibility programs, such as yoga, can also be helpful. Exercising three times a week is optimal.
  
• Mind–body treatments have been successful in some patients, including hypnotherapy, cognitive behavioral feedback, electromyography (EMG) biofeedback, and meditation programs.
  
• Acupuncture is currently under investigation as a potential treatment.
  

Many medications have been tried, but few have a significant effect on symptoms. Nonsteroidal anti–inflammatory drugs (e.g., ibuprofen) and acetaminophen (Tylenol) may be helpful in some patients. Antidepressant medications, including tricyclic antidepressants (e.g., desipramine) and selective serotonin reuptake inhibitors (e.g., Prozac), are effective in some patients.