Fibromyalgia syndrome (FMS) is a chronic noninflammatory, nonautoimmune central afferent processing disorder leading to a diffuse pain syndrome as well as other symptoms.
Similar to patients with other chronic pain disorders, functional magnetic resonance images (MRIs) show expanded receptive fields for central pain perception and emotional modulation in patients with fibromyalgia.
The most effective drugs for FMS are tricyclic agents (TCAs), dual reuptake inhibitors, and anticonvulsants, which downregulate sensory processing.
Opioids and corticosteroids are not effective in the treatment of fibromyalgia and should be avoided.
Patient education, aerobic exercise, and cognitive behavioral therapy are important adjuncts to medical therapy of FMS.