Fibromyalgia includes widespread musculoskeletal aches, pain and stiffness, soft tissue tenderness, general fatigue, and sleep disturbances. Fibromyalgia pain has been described as deep, throbbing, twitching, stabbing, and shooting musculoskeletal pain. These symptoms manifest in varying intensities that come and go over time.


Fatigue, sleep disturbance, irritable bowel and bladder, headaches and migraines, restless-legs syndrome, impaired memory and concentration, neurologic symptoms, and impaired coordination.


Painful mastication (chewing); sleep disturbances, including bruxism (a chronic clenching or grinding teeth while sleeping or awake), diffuse musculoskeletal pain in trunk, extremities, and head and neck.


Pain management with nonsteroidal anti-inflammatory drugs (NSAIDs), behavioral therapy, sleep-habit counseling, and exercise. Newer treatments may include non-narcotic pain relievers (e.g., tramadol) or low doses of antidepressants (e.g., TCAs, serotonin uptake inhibitors) or benzodiazepines.


Adequate with continued medication and behavioral-therapy management.

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