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1. Fibromyalgia (FM) is a hypersensitivity syndrome characterized by hyperalgesia.

2. More women are affected, female:male ratio is 10:1.

3. Patients often complain of diffuse myalgias, all-day stiffness, excessive fatigue, and non-restorative sleep. Can co-exist with depression, psychological issues and other nebulous conditions.

4. Symptoms must be present at a similar level for 2-3 mths, with pain above and below the waist; Ddx to exclude - hypothyroidism, OSA, anaemia.

5. Inx - FBC, ESR, CRP, LFT.

6. Non-pharmacologic therapy with CBT, exercise is the the foundation of FM management. Others - SSRI, Tramadol (note risk of serotonin syndrome), Pregabalin, Gabapentin.


1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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