The Clinical Spectrum of Fibromyalgia and Its Treatment: An Overview

The story of fibromyalgia is lengthy, intricate, often frustrating—but always fascinating. Starting from early nineteenth-century conceptions about the entity of “neurasthenia,” moving on into early twentieth-century coining of the presumably inflammatory condition of “fibrositis” and on through the multiple definitions, redefinitions, and ever-changing classifications and sets of diagnostic criteria developed over recent decades, the syndrome of fibromyalgia serves as a paradigm for complex disorders affecting the central as well as the autonomic and peripheral nervous systems, and as an intriguing example for the way in which future insight into medical complexity calls for the most eclectic and multidisciplinary of approaches. Indeed, due to its clinical and etiopathogenetic complexity, the fibromyalgia syndrome (FMS) challenges both physicians and patients and necessitates a truly holistic and open-minded scientific attitude, together with the application of patience, empathy, and in short—medicine at its best. While the many aspects of FMS are described in detail in the chapters of this book, it is the purpose of this chapter to provide a brief overview of both the clinical manifestations and the current therapeutic strategies.