From the Guidelines
No, chronic pain syndrome and fibromyalgia are not the same condition, though they share some similarities. Chronic pain syndrome is a broad term that refers to persistent pain lasting longer than three to six months that significantly affects a person's daily functioning. It can result from various underlying conditions including injuries, surgeries, or diseases. Fibromyalgia, on the other hand, is a specific disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues, as noted in the EULAR evidence-based recommendations for the management of fibromyalgia syndrome 1.
Key Differences and Similarities
- Fibromyalgia features specific tender points throughout the body and is thought to involve central sensitization, where the brain amplifies pain signals.
- Treatment approaches overlap, often including medications like duloxetine, pregabalin, or amitriptyline, along with non-pharmacological approaches such as physical therapy, cognitive behavioral therapy, and exercise, as recommended in the EULAR revised recommendations for the management of fibromyalgia 1.
- While both conditions involve persistent pain and can significantly impact quality of life, fibromyalgia has more specific diagnostic criteria and is considered a distinct condition within the broader category of chronic pain syndromes.
- The American College of Rheumatology (ACR) classification criteria for FMS are the most commonly used in clinical and therapeutic research, highlighting the distinct nature of fibromyalgia 1.
Management and Treatment
- The management of fibromyalgia should aim at improving health-related quality of life, balancing benefit and risk of treatment, and often requires a multidisciplinary approach with a combination of non-pharmacological and pharmacological treatment modalities, as outlined in the EULAR revised recommendations 1.
- Non-pharmacological management options include aerobic and strengthening exercise, cognitive behavioral therapies, and multicomponent therapies, which have been shown to be effective in managing fibromyalgia symptoms 1.
- Pharmacological management options, such as amitriptyline, duloxetine, and pregabalin, can also be effective in reducing pain and improving function in patients with fibromyalgia, as noted in the EULAR evidence-based recommendations 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Definition and Diagnosis
- Fibromyalgia is a chronic, centralized pain syndrome characterized by disordered processing of painful stimuli 2.
- It is diagnosed more frequently in women and occurs globally, affecting 2% of people in the United States 2.
- The American College of Rheumatology criteria or the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks-American Pain Society Pain Taxonomy diagnostic criteria can diagnose fibromyalgia 2.
- Chronic pain syndrome is considered a pain processing disorder, and its pathophysiology is not completely understood 3.
Comparison of Chronic Pain Syndrome and Fibromyalgia
- Fibromyalgia is a type of chronic pain syndrome, but not all chronic pain syndromes are fibromyalgia 3.
- Fibromyalgia is characterized by chronic widespread pain, sleep disturbance, depression, fatigue, and cognitive dysfunction 4, 5.
- Chronic pain syndromes, including fibromyalgia, require a multimodal, targeted symptom management approach that emphasizes self-management 3.
Treatment Options
- A multidisciplinary approach that incorporates nonpharmacologic therapies and medications to address problematic symptoms is most effective for fibromyalgia 2.
- Duloxetine, milnacipran, pregabalin, and amitriptyline are potentially effective medications for fibromyalgia 2, 5, 3.
- Nonsteroidal anti-inflammatory drugs and opioids have not demonstrated benefits for fibromyalgia and have significant limitations 2.
- Low-dose naltrexone may be a viable option for severe refractory fibromyalgia, but the information base is currently limited, and studies are conflicting 6.