Beyond pain in fibromyalgia: insights into the symptom of fatigue
Open Access
- 1 January 2013
- journal article
- review article
- Published by Springer Science and Business Media LLC in Arthritis Research & Therapy
- Vol. 15 (6), 221
- https://doi.org/10.1186/ar4395
Abstract
Fatigue is a disabling, multifaceted symptom that is highly prevalent and stubbornly persistent. Although fatigue is a frequent complaint among patients with fibromyalgia, it has not received the same attention as pain. Reasons for this include lack of standardized nomenclature to communicate about fatigue, lack of evidence-based guidelines for fatigue assessment, and a deficiency in effective treatment strategies. Fatigue does not occur in isolation; rather, it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain, unrefreshing sleep, anxiety, depression, cognitive difficulties, and so on. Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physiological mechanisms. Therefore, fatigue assessment in clinical and research settings must consider this multi-dimensionality. While no clinical trial to date has specifically targeted fatigue, randomized controlled trials, systematic reviews, and meta-analyses indicate that treatment modalities studied in the context of other fibromyalgia symptoms could also improve fatigue. The Outcome Measures in Rheumatology (OMERACT) Fibromyalgia Working Group and the Patient Reported Outcomes Measurement Information System (PROMIS) have been instrumental in propelling the study of fatigue in fibromyalgia to the forefront. The ongoing efforts by PROMIS to develop a brief fibromyalgia-specific fatigue measure for use in clinical and research settings will help define fatigue, allow for better assessment, and advance our understanding of fatigue.Keywords
This publication has 141 references indexed in Scilit:
- Peripheral pain mechanisms in chronic widespread painBest Practice & Research Clinical Rheumatology, 2011
- Milnacipran for the treatment of fibromyalgia in adults: A 15-week, multicenter, randomized, double-blind, placebo-controlled, multiple-dose clinical trialClinical Therapeutics, 2008
- Identifying the clinical domains of fibromyalgia: Contributions from clinician and patient delphi exercisesArthritis Care & Research, 2008
- A six‐month randomized controlled trial of exercise and pyridostigmine in the treatment of fibromyalgiaArthritis & Rheumatism, 2008
- A Brief Measure for Assessing Generalized Anxiety DisorderArchives of Internal Medicine, 2006
- Health status and disease severity in fibromyalgia. Results of a six‐center longitudinal studyArthritis & Rheumatism, 1997
- The multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigueJournal of Psychosomatic Research, 1995
- The prevalence and characteristics of fibromyalgia in the general populationArthritis & Rheumatism, 1995
- Dimensional assessment of chronic fatigue syndromeJournal of Psychosomatic Research, 1994
- Development of a fatigue scaleJournal of Psychosomatic Research, 1993