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The complexities of fibromyalgia and its comorbidities

Lichtenstein, Adia,b; Tiosano, Shmuela,b; Amital, Howarda,b

Current Opinion in Rheumatology: January 2018 - Volume 30 - Issue 1 - p 94–100
doi: 10.1097/BOR.0000000000000464

Purpose of review Fibromyalgia syndrome (FMS) is defined as chronic, widespread musculoskeletal pain and tenderness with concomitant mood and cognitive dysfunction. Several comorbidities have been reported to be associated with FMS. We reviewed the literature concerning the most noteworthy chronic conditions associated with FMS.

Recent findings There is mounting evidence displaying the concurrence of fibromyalgia and coexisting medical and psychiatric conditions. Such comorbidities may blur the classical clinical presentations and erroneously lead to misinterpretation of disease activity. The recognition of this fact should be underlined, as misrecognition may lead to excessive therapy and avoidable side-effects of medications on the one hand and to a better handling of FMS on the other hand, leading to improved clinical outcomes.

Summary A greater proportion of psychiatric and rheumatologic disorders are associated with FMS patients than the population. Consequently, physicians treating patients with either condition should keep in mind that these patients may have such comorbidities and should be treated accordingly.

aDepartment of Medicine ‘B’, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer

bSackler Faculty of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel

Correspondence to Howard Amital, MD, MHA, Department of Medicine ‘B’, Sheba Medical Center, Tel-Hashomer 52621, Israel. Tel: +972 3 5302661; fax: +972 3 5304796; e-mail:

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