Article: A conservative, cost-effective approach to fibromyalgia: researchers have hypothesized that fibromyalgia may be triggered by Lyme disease, hypothyroidism, viral infections, or autoimmune disorders. It is also associated with physical or emotional trauma and childhood abuse.(Recertification Refresher)(Cover story)

Fibromyalgia syndrome (FMS) is characterized as chronic, widespread musculoskeletal pain accompanied by fatigue and several tender points on examination (see Figure 1). (1) A form of soft tissue rheumatism causing pain and stiffness around joints as well as in muscles and bones, FMS is not associated with arthritis, inflammation, or musculoskeletal or degenerative disorders. (2) Associated symptoms may include sleep disturbance, anxiety, depression, headaches, and irritable bowel syndrome (IBS). (3)

[FIGURE 1 OMITTED]

Fibromyalgia was first described as fibrositis in mid-19th century Europe. (4) The American College of Rheumatology established criteria ...

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