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Abstract

Fibromyalgia (FM) is a chronic disorder that has been found to negatively impact quality-of-life, physical, emotional, and social functioning, personal relationships, and working productivity. Employees with FM are 2 to 3 times less productive than healthy workers. FM-related workplace absenteeism accounts for an average of 30 days each year. As their severity of illness rises, FM workers are often forced to change job positions, work site tasks, and the number of hours worked. FM poses a significant economic burden costing society tens of thousands of dollars per patient each year. FM patients frequently suffer with higher levels of pain, significant disruptions in sleep, and require more medication when compared to other chronic pain conditions. Timely diagnosis continues to be a problem most likely due to the diversity of presentation, comorbid illnesses, absence of quantitative measurements (e.g. laboratory, imaging), and poor understanding of diagnostic criteria. Moreover, prescribing patterns vary considerably and treatment often remains inadequate. Research indicates that only 31% of FM patients are prescribed medications of proven efficacy including pregablin, amitriptyline, cyclobenzaprine, duloxetine, gabapentin, tramadol, or milnacipran within the first year of diagnosis. In order to address the potential shortcomings of pharmacotherapy related to prescribing, poor response rates, and patient dissatisfaction, it becomes very important to incorporate a combination of both pharmacological and non-pharmacological approaches. Additionally, a patient-centered, multi-disciplinary strategy which uses education and non-pharmacologic interventions such as aerobic and strengthening exercise should be a mainstay for all treatment plans.

Keywords: Fibromyalgia; Comorbidities; Quality-of-life; Multidisciplinary; Pharmacotherapy; Exercise; Cognitive behavioral therapy; Education