Book contents
- Emergency Department Analgesia
- Emergency Department Analgesia
- Copyright page
- Contents
- Contributors
- Foreword
- Preface
- Acknowledgments
- Abbreviations
- General considerations
- Chief complaints and diagnoses
- Abdominal aortic aneurysm
- Aortic dissection
- Arthritis
- Biliary tract pain
- Bites and stings – marine
- Bites and stings – terrestrial
- Breast pain
- Burns
- Bursitis and periarticular inflammation
- Cancer and tumor pain
- Cardiac chest pain
- Chest wall trauma
- Chronic low-back pain
- Cluster headache
- Corneal abrasion
- Cystitis, urethritis, and prostatitis
- Dysmenorrhea
- Endometriosis
- Esophageal spasm
- Fibromyalgia
- Gastritis and peptic ulcer disease
- Gastroesophageal reflux disease
- Hemorrhoids and perianal pain
- Migraine and undifferentiated headache
- Mucositis and stomatitis
- Neck and back pain – mechanical strain
- Neck and back pain – radicular syndromes
- Neck and back pain – spinal spondylitic syndromes
- Neuropathy – complex regional pain syndrome
- Neuropathy – diabetic
- Neuropathy – HIV related
- Neuropathy – overview
- Neuropathy – phantom limb pain
- Ocular inflammation
- Odontalgia
- Orthopedic extremity trauma – sprains, strains, and fractures
- Osteoporotic vertebral compression fracture
- Otitis media and externa
- Pancreatitis
- Pharyngitis
- Postdural puncture headache
- Post-herpetic neuralgia
- Renal colic
- Sialolithiasis
- Sickle cell crisis
- Temporomandibular disorders
- Tension-type headache
- Trigeminal neuralgia
- Undifferentiated abdominal pain
- Tables
Fibromyalgia
from Chief complaints and diagnoses
Published online by Cambridge University Press: 18 December 2009
Edited by
Book contents
- Emergency Department Analgesia
- Emergency Department Analgesia
- Copyright page
- Contents
- Contributors
- Foreword
- Preface
- Acknowledgments
- Abbreviations
- General considerations
- Chief complaints and diagnoses
- Abdominal aortic aneurysm
- Aortic dissection
- Arthritis
- Biliary tract pain
- Bites and stings – marine
- Bites and stings – terrestrial
- Breast pain
- Burns
- Bursitis and periarticular inflammation
- Cancer and tumor pain
- Cardiac chest pain
- Chest wall trauma
- Chronic low-back pain
- Cluster headache
- Corneal abrasion
- Cystitis, urethritis, and prostatitis
- Dysmenorrhea
- Endometriosis
- Esophageal spasm
- Fibromyalgia
- Gastritis and peptic ulcer disease
- Gastroesophageal reflux disease
- Hemorrhoids and perianal pain
- Migraine and undifferentiated headache
- Mucositis and stomatitis
- Neck and back pain – mechanical strain
- Neck and back pain – radicular syndromes
- Neck and back pain – spinal spondylitic syndromes
- Neuropathy – complex regional pain syndrome
- Neuropathy – diabetic
- Neuropathy – HIV related
- Neuropathy – overview
- Neuropathy – phantom limb pain
- Ocular inflammation
- Odontalgia
- Orthopedic extremity trauma – sprains, strains, and fractures
- Osteoporotic vertebral compression fracture
- Otitis media and externa
- Pancreatitis
- Pharyngitis
- Postdural puncture headache
- Post-herpetic neuralgia
- Renal colic
- Sialolithiasis
- Sickle cell crisis
- Temporomandibular disorders
- Tension-type headache
- Trigeminal neuralgia
- Undifferentiated abdominal pain
- Tables
Summary
Fibromyalgia is marked by high interpatient variability in both clinical course and efficacy of particular therapies. Fibromyalgia pain does not result from peripheral nociceptor stimulation but instead arises from deficient CNS processing and modulation of pain signals. Tricyclic antidepressants (TCAs) and related drugs have some efficacy when compared with placebo in clinical trials. In addition to TCAs and antidepressants, the other commonly seen approach to treating fibromyalgia pain is the use of anticonvulsants. In fibromyalgia patients taking long-term opioids, a methodologically rigorous study shows that administration of the non-ergot dopamine agonist pramipexole significantly reduces pain and improves myriad quality-of-life indices. The benzodiazepines are also associated with mixed results in fibromyalgia trials. Given the lack of inflammatory pathophysiology in fibromyalgia, it is not surprising that no data support use of corticosteroids or NSAIDs in treating fibromyalgia pain.
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- Emergency Department AnalgesiaAn Evidence-Based Guide, pp. 204 - 212Publisher: Cambridge University PressPrint publication year: 2008