Qureshi Aniqa G, Jha Saurav K, Iskander John, Avanthika Chaithanya, Jhaveri Sharan, Patel Vithi Hitendra, Rasagna Potini Bhuvana, Talha Azam Ahmad
Medicine and Surgery, Jinggangshan Medical University, Jian, CHN.
Internal Medicine, Kankai Hospital, Birtamode, NPL.
Cureus. 2021 Oct 11;13(10):e18692. doi: 10.7759/cureus.18692. eCollection 2021 Oct.
The World Health Organization regards chronic pain to be a public health concern. In clinical medicine, fibromyalgia (FM) is the most prevalent chronic widespread pain disease. In terms of impairment, consumption of health and social resources, and impact on primary and speciality care systems, it has reached worrisome proportions. This disease is frequently managed by primary care providers. Because of its intricacy, fibromyalgia diagnosis and treatment can be difficult. Fibromyalgia is a controversial condition. It might appear ill-defined in comparison to other pain conditions, with no clear knowledge of pathophysiology and hence no particular targeted therapy. This invariably sparks debates and challenges. There is no obvious cut-off point that distinguishes FM from non-FM. The diagnosis of fibromyalgia has been complicated by several factors, including patients' health-seeking behaviour, symptom identification, and physician labelling of the disease. Fibromyalgia is currently considered a centralized pain condition, according to research that has improved our understanding of its etiopathology. A multidisciplinary strategy combining pharmacological and non-pharmacological therapies based on a biopsychosocial paradigm can result in effective therapy. Cultural and psychosocial variables appear to be a recent development in fibromyalgia, and they appear to have a larger influence on physician diagnosis than severe symptom levels in FM patients. Although physicians rely on FM criteria as the only way to classify FM patients in research and clinical settings, some crucial elements of the diagnostic challenge of fibromyalgia remain unsolved - invalidation, psychosocial variables, and diverse illness manifestation are some examples. Beyond the existing constructional scores, physicians' judgment gained in real communicative contexts with patients, appears to be the only dependable route for a more accurate diagnosis for fibromyalgia. We have performed an exhaustive review of the literature using the keywords "Fibromyalgia", "challenges" and "diagnosis" in PubMed and Google Scholar indexes up to September 2021. This article aims to examine the causes, diagnosis, and current treatment protocols of FM, as well as discuss some continuing debates and diagnostic challenges which physicians face in accurately diagnosing fibromyalgia.
世界卫生组织将慢性疼痛视为一个公共卫生问题。在临床医学中，纤维肌痛（FM）是最常见的慢性广泛性疼痛疾病。在损伤、健康和社会资源消耗以及对初级和专科护理系统的影响方面，它已达到令人担忧的程度。这种疾病通常由初级护理提供者进行管理。由于其复杂性，纤维肌痛的诊断和治疗可能会很困难。纤维肌痛是一种有争议的病症。与其他疼痛病症相比，它可能显得定义不明确，对病理生理学缺乏清晰认识，因此没有特定的靶向治疗方法。这 invariably 引发了争论和挑战。没有明显的界限来区分纤维肌痛和非纤维肌痛。纤维肌痛的诊断因多种因素而变得复杂，包括患者的求医行为、症状识别以及医生对该疾病的诊断标签。根据增进了我们对其病因病理学理解的研究，纤维肌痛目前被认为是一种中枢性疼痛病症。基于生物心理社会范式的多学科策略，将药物治疗和非药物治疗相结合，可以产生有效的治疗效果。文化和社会心理变量似乎是纤维肌痛领域的一个新发展，而且它们对医生诊断的影响似乎比对纤维肌痛患者严重症状水平的影响更大。尽管医生在研究和临床环境中依靠纤维肌痛标准作为对纤维肌痛患者进行分类的唯一方法，但纤维肌痛诊断挑战中的一些关键因素仍未得到解决——例如无效化、社会心理变量和多样的疾病表现。除了现有的结构性评分外，医生在与患者实际交流情境中获得的判断，似乎是对纤维肌痛进行更准确诊断的唯一可靠途径。我们在截至2021年9月的PubMed和谷歌学术索引中，使用关键词“纤维肌痛”“挑战”和“诊断”对文献进行了详尽的综述。本文旨在研究纤维肌痛的病因、诊断和当前治疗方案，并讨论医生在准确诊断纤维肌痛时面临的一些持续争论和诊断挑战。
