A chronic pain syndrome diagnosed by the presence of widespread body pain

Pathophysiology

• Malfunctioning of the CNS, heightened pain perception accompanied by ineffective pain inhibition and/or modulation
• This increased response to peripheral stimuli causes hyperalgesia, allodynia, and referred pain across multiple spinal segments, resulting in chronic widespread pain and decreased tolerance to sensory input of the musculoskeletal system.

Risk factors:

• Family Hx of Fibromyalgia
• Rheumatological conditions - Higher prevalence in patients with RA, SLE, OA
• Age: 20-60 years
• Female sex

PC

• chronic pain: at multiple site, sometimes 'pain all over'
• lethargy
• cognitive impairment: 'fibro fog'
• sleep disturbance, headaches, dizziness are common

Examination:

• Diffuse tenderness to palpation on physical exam