Fibromyalgia

Abstract

Fibromyalgia (FM) represents one of a group of soft tissue pain disorders that affect muscles and soft tissues, such as tendons and ligaments. The widespread body pain is usually associated with a number of manifestations that include fatigue, headache, sleep disorders, and cognitive disturbances. FM is not uncommon. In spite of being under-recognized, it is estimated to affect 2-3% of the worldwide general population. The multiple symptoms of FM are shared with numerous other medical disorders such as autoimmune rheumatic diseases, psychiatric disorders, and other chronic pain conditions. Additionally, there is no measurable or perceived structural damage, and patients have no diagnostic imaging or laboratory abnormal results. For the aforementioned reasons, most of FM patients are, at least initially, subject to wrong or delayed diagnosis. The existence of a comorbidity with a disease can significantly entangle its course starting from puzzling the diagnosis and ending with worsening the prognosis. FM has been linked to a broad spectrum of disorders that occur in FM patients in a higher frequency than that of the control populations. These disorders include cervical spondylosis, low back pain, spondyloarthropathies, rheumatoid arthritis, systemic lupus erythematosus, obesity, obstructive sleep apnea, hypertension, and last but not least coronary atherosclerosis. On the other hand, FM appreciably coexists with a list of diseases that are mainly autoimmune, chronic inflammatory, or rheumatic diseases, including but not limited to rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, psoriatic arthritis, and inflammatory bowel disease. We here discuss the mutual impact of FM and its comorbidities from the diagnostic, therapeutic, prognostic, and future research points of view.