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Fibromialgia

Last reviewed: 14 Sep 2025
Last updated: 08 Dec 2023

Summary

Definition

History and exam

Key diagnostic factors

  • dor e rigidez disseminadas
  • perturbação do sono/fadiga
  • dificuldades cognitivas
Full details

Other diagnostic factors

  • alodinia e/ou hiperalgesia
  • hipersensibilidade difusa ao exame físico
  • sensibilidade a estímulos sensoriais
  • cefaleias
  • distúrbio do humor
  • dormência/sensação de formigamento
Full details

Risk factors

  • história familiar de fibromialgia (FM)
  • doenças reumatológicas
  • idade entre 20 e 60 anos
  • sexo feminino
  • eventos estressantes
  • problemas do sono
  • infecções
  • deficiência de vitamina D
Full details

Diagnostic investigations

1st investigations to order

  • diagnóstico clínico
Full details

Investigations to consider

  • velocidade de hemossedimentação (VHS)/proteína C-reativa
  • teste da função tireoidiana
  • Hemograma completo
  • fator reumatoide
  • anticorpo antipeptídeo citrulinado cíclico (CCP)
  • fator antinuclear e anticorpo anti-DNA
  • nível de vitamina D
  • creatinina quinase
  • ferritina
  • oximetria/polissonografia noturna
Full details

Treatment algorithm

ONGOING

fibromialgia leve ou moderada

fibromialgia grave

Contributors

Authors

Matthew A. Bartlett, MB, BCh, BAO

Assistant Professor of Medicine

Fibromyalgia Clinic

Division of General Internal Medicine

Department of Internal Medicine

Mayo Clinic

Rochester

MN

Disclosures

MAB declares that he owns stock in Johnson & Johnson. No products developed or marketed by Johnson & Johnson are included in this topic.

Christopher V. Anstine, MD

Assistant Professor of Medicine

Fibromyalgia Clinic

Division of General Internal Medicine

Department of Internal Medicine

Mayo Clinic

Rochester

MN

Disclosures

CVA declares he has no competing interests.

Acknowledgements

Dr Matthew A. Barlett and Dr Christopher V. Anstine would like to gratefully acknowledge Dr Daniel J. Clauw and Dr Lisa Ware Corbin, previous contributors to this topic.

Disclosures

LWC and DJC declare that they have no competing interests.

Peer reviewers

Don Goldenberg, MD

Emeritus Professor of Medicine

Tufts University School of Medicine

Boston

MA

Disclosures

DG declares that he has no competing interests.

Robert Bennett, MD

Professor of Medicine and Nursing Research

Oregon Health & Science University

Portland

OR

Disclosures

RB declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Wolfe F, Clauw DJ, Fitzcharles MA, et al. 2016 revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum. 2016 Dec;46(3):319-29. Abstract

Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2017 Feb;76(2):318-28.Full text  Abstract

Goldenberg DL, Burckhardt C, Crofford L. Management of fibromyalgia syndrome. JAMA. 2004 Nov 17;292(19):2388-95.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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