The Difficulties in Developing and Implementing Fibromyalgia Guidelines

Abstract

Fibromyalgia syndrome (FMS) is increasing in prevalence both in Europe and the rest of the developed world. In 1995 the prevalence was estimated in the USA as roughly 1 in 50 with a female to male ratio of 6:1 (Wolfe F. et al, 1995). In 1998 the German health survey identified similar figures. In 2010 a survey of five European countries estimated it to be now as high as 1 in 30 (Branco et al, 2010), with a sex ratio of 2 to 1. This ratio varies widely in different countries being as high as forty to one in Brazil (Senna et al, 2004). The presence of the sex ratio and it's variability is one of many hotly debated areas in FMS. Why prevalence of the syndrome should be increasing is another area under discussion, although it is not as controversial as to how such a subjective condition should be accurately diagnosed and effectively treated; there have been many guidelines constructed by experts to assist in these two domains and this is the focus of the following chapter.