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Pain Research and Treatment
Volume 2012, Article ID 184835, 8 pages
Review Article

The Clinical Concept of Fibromyalgia as a Changing Paradigm in the Past 20 Years

1Division of Rheumatology, McGill University, Montreal, QC, Canada H3G 1A4
2Alan Edwards Pain Management Unit, McGill University Health Center, Montreal, QC, Canada H3G 1A4
3Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada H3G 1A4
4Section of Rheumatology, Department of Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA

Received 20 April 2011; Accepted 25 July 2011

Academic Editor: Chad Boomershine

Copyright © 2012 Mary-Ann Fitzcharles and Muhammad B. Yunus. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Fibromyalgia (FMS) is a valid clinical condition that affects 2%–4% of the population with a pivot symptom of widespread body pain. The cause and cure of FMS are as yet unknown. The concept of FMS has evolved over the past two decades to incorporate symptoms beyond pain as contributing to the global spectrum of suffering. FMS is now recognized to be grounded in the neurological domain with evidence of dysregulation of pain processing. Appreciation of the neurophysiologic mechanisms operative in FMS has contributed to rational treatment recommendations, although a “gold standard treatment” does not currently exist. Ideal treatments for FMS patients should be individualized with emphasis on active patient participation, good health practices, and multimodal intervention, incorporating nonpharmacologic and pharmacologic treatments. Predictors of outcome, which is favourable in over 50% of patients, are unknown, but those with better outcome do more physical activity and use fewer medications.