Fibromyalgia: Recent Advances in Diagnosis, Classification, Pharmacotherapy and Alternative Remedies

Abstract

Fibromyalgia (FM) is a syndrome that does not present a well-defined underlying organic disease. FM is a condition which has been associated with diseases such as infections, diabetes, psychiatric or neurological disorders, rheumatic pathologies, and is a disorder that rather than diagnosis of exclusion requires positive diagnosis. A multidimensional approach is required for the management of FM, including pain management, pharmacological therapies, behavioral therapy, patient education, and exercise. The purpose of this review is to summarize the recent advances in classification criteria and diagnostic criteria for FM as well as to explore pharmacotherapy and the use of alternative therapies including the use of plant bioactive molecules.

Keywords: alternative therapies; diagnosis; fibromyalgia; natural products; pharmacotherapy; plant extracts.

Figure 1

Widespread Pain Index from ACR 1990 criteria for the classification of fibromyalgia and related regions.

Figure 2

Symptom Severity scale (SSS) and Extent of Somatic Symptoms (ESS).

Figure 3

Structure formulae of some cannabinoids and related compounds. Numbers correspond to compound names cited in the text.

Figure 4

Structure formulae of some opioids and related compounds. Numbers correspond to molecules cited in the text.

Figure 5

Structure formulae of some gabapentinoids. Numbers correspond to molecules cited in the text.

Figure 6

Chemical structure of some serotonin and noradrenaline reuptake inhibitors and a tricyclic antidepressant. Numbers correspond to molecules cited in the text.

Figure 7

Chemical structure of some natural compounds with antinociceptive activity.