ABSTRACT
Neurological examination typically is within normal limits. General physical examination may be pertinent to finding coexisting medical problems. Educational emphasis should continue on improving and maintaining function, mind–body therapies, the need for the patient to be an active member of the treatment team, and full information regarding all medications used and nondrug treatment options should be shared with patients. Physicians must be very familiar with all the pharmacological aspects of medications, particularly the side effects, as many fibromyalgia syndrome (FMS) patients are very sensitive to medication effects and especially their side effects, particularly those dealing with fatigue, sedation, and cognitive decrement. Nonpharmacological treatment should be encouraged for these patients. Muscle relaxants are useful, along with analgesics, to help deconditioned patients get through appropriate early and later exercise and rehabilitation. The primary goal of a cognitive behavioral therapy program is to help patients develop an active self-management approach to coping with their FMS.
