Fibromyalgia syndrome: preventive, social and economic aspects.

Unit of Rheumatology, Hospital S. Eugenio, Rome, Italy.
Reumatismo 09/2011; 60 Suppl 1:70-8. DOI: 10.4081/reumatismo.2008.1s.70
Source: PubMed


There many open questions concerning the concept of primary prevention in FM. Diagnostic or classification criteria are not universally accepted, and this leads to difficulties in establishing the onset and duration of the disease. In the case of FM, primary prevention may consist of the immediate care of acute pain or treatment for affective disturbances as we do not have any specific laboratory or instrumental tests to determine risk factors of the disease. The goal of secondary prevention is early detection of the disease when patients are largely asymptomatic and intervention improves outcome. Screening allows for identification of an unrecognized disease or risk factor, which, for potential FM patients, includes analysis of tender points, Fibromyalgia Impact Questionnaire (FIQ), pain location and intensity, and fatigue and sleep complaints. Tertiary prevention inhibits further deterioration or reduces complications after the disease has developed. In FM the aim of treatment is to decrease pain and increase function via multimodal therapeutic strategies, which, in most cases, includes pharmacological and non-pharmacological interventions. Patients with FM are high consumers of health care services, and FM is associated with significant productivity-related costs. The degree of disability and the number of comorbidities are strongly associated with costs. An earlier diagnosis of FM can reduce referral costs and investigations, thus, leading to a net savings for the health care sector. However, every social assessment is closely related to the socio-economic level of the general population and to the legislation of the country in which the FM patient resides.

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Available from: Manuela Di Franco, Oct 07, 2015
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    ABSTRACT: A new definition of fibromyalgia syndrome (FMS) based on symptoms and without tender points is discussed from a rheumatological viewpoint. The German Fibromyalgia Association (DFV) developed a questionnaire on potential symptoms in FM based on a list of symptoms established by members of the DFV. The questionnaire was sent to all 3,996 members of the DFV. Of the 753 questionnaires 699 were returned (95% women, most frequent age between 50-60 years) and evaluated. The rank order of the most frequent symptoms (>or=97% of the respondents) was muscle pain with varying locations, low back pain, fatigue, morning stiffness, non-restorative sleep, concentration problems, lack of energy, low productivity and forgetfulness. The key symptoms of FM are chronic widespread pain, non-restorative sleep and subjective disabilities. The frequency of general and extra-musculoskeletal symptoms underlines that FMS is more than just a "pain disorder".
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