Brazilian Society of Rheumatology’s fibromyalgia treatment guidelines – part I: monitoring and non-pharmacological management

Abstract

Fibromyalgia is one of the most prevalent rheumatologic conditions, affecting millions of individuals worldwide. It is characterized by widespread chronic pain accompanied by symptoms such as fatigue, sleep disturbances, and cognitive impairments. In Brazil, fibromyalgia is the second most common rheumatologic disorder, with a reported prevalence ranging from 2.5% to 5.5%, leading to a substantial economic burden due to high direct and indirect healthcare costs. The pathophysiology of fibromyalgia involves alterations in central pain processing, often in conjunction with comorbidities such as depression, anxiety, and irritable bowel syndrome, which exacerbate symptom severity and negatively impact patients’ quality of life. Effective management requires a structured, interdisciplinary approach that emphasizes treatment adherence and patient education. This guidelines from the Brazilian Society of Rheumatology (SBR) provide an updated review of the 2010 recommendations, incorporating recent evidence to refine both pharmacological and non-pharmacological therapeutic strategies, and are presented in two separate articles, covering aspects of patient monitoring, non-pharmacological interventions, and pharmacological treatments. This approach underscores commitment to comprehensive, evidence-based, and patient-centered care. This first article focuses on the evaluation of monitoring strategies and non-pharmacological interventions for managing fibromyalgia. Fibromyalgia is one of the most prevalent rheumatologic conditions, affecting millions of individuals worldwide. It is characterized by widespread chronic pain accompanied by symptoms such as fatigue, sleep disturbances, and cognitive impairments. In Brazil, fibromyalgia is the second most common rheumatologic disorder, with a reported prevalence ranging from 2.5% to 5.5%, leading to a substantial economic burden due to high direct and indirect healthcare costs. The pathophysiology of fibromyalgia involves alterations in central pain processing, often in conjunction with comorbidities such as depression, anxiety, and irritable bowel syndrome, which exacerbate symptom severity and negatively impact patients’ quality of life. Effective management requires a structured, interdisciplinary approach that emphasizes treatment adherence and patient education. This guidelines from the Brazilian Society of Rheumatology (SBR) provide an updated review of the 2010 recommendations, incorporating recent evidence to refine both pharmacological and non-pharmacological therapeutic strategies, and are presented in two separate articles, covering aspects of patient monitoring, non-pharmacological interventions, and pharmacological treatments. This approach underscores commitment to comprehensive, evidence-based, and patient-centered care. This first article focuses on the evaluation of monitoring strategies and non-pharmacological interventions for managing fibromyalgia.