Fibromyalgia: Literature Review


  • Maula Al Farisi Medical Faculty University of Lampung
  • Muhartono Fakultas Kedokteran Universitas Lampung
  • Anggi Setiorini
  • M. Praditia Ansor Fakultas Teknik Universitas Lampung



Fibromyalgia, psychosomatic symptom, pain chronic


Musculoskeletal chronic pain is characterized by pain and loss of function in the joints, tendons, ligaments, bones, and or muscles lasting for greater than equal to three months. There are several diseases caused by rheumatic disorders that have been identified, such as osteoarthritis, gout, rheumatoid arthritis, fibromyalgia. However, until now, chronic rheumatic disorders have become a world problem, namely “fibromyalgia”. Fibromyalgia is a syndrome characterized by generalized chronic musculoskeletal pain, hyperalgesia in specific points and psychosomatic symptoms, such as fatigue, sleep disturbances, anxiety, depression, cognitive dysfunction, headache, and gastrointestinal disorders. The prevalence of fibromyalgia in the world is higher in women than in men, which is between 2,4% to 6,8% with the ratio between women and men is 2:1. The etiology of fibromyalgia is idiopathic, but it is suspected that psychosocial factors play a role in the development of fibromyalgia. Currently, the diagnose of fibromyalgia can only be made by a comprehensive clinical examination according to the ACR (American College of Rheumatology) criteria. Therapy of fibromyalgia requires an optimal approach to the success of treatment. Therapies that can be done in patients with fibromyalgia include pharmacological therapy, complement therapy, cognitive behavioural therapy, psychotherapy and physical therapy.


Crofford LJ. Chronic Pain: Where the body meets the brain. Transaction of the American Clinical and Climatological Association. 2015;126:167-83.

Bushnell MC, Ceko M, Low LA. Cognitive and emotional control of pain and it’s disruption in chronic pain. Journal of Nature Reviews Neuroscience. 2013;14(7):502-11.

Bazzichi L, Giacomelli C, Consensi A, Giorgi V, Batticciotto A, DiFranco M. One year in review 2020: fibromyalgia. Journal of Clinical and Experimental Rheumatology. 2020;38(Suppl 123):S3-S28.

Choi DH, Kim HS. Quantitative anaylsis of nailfold capillary morphology in patients with fibromyalgia. Journal of Korean International Medicine. 2015;30:531-7.

Marques AP, Matsutani LA, Yuan SL, Berssaneti AA, Santo AS. Prevalence of fibromyalgia: literature review update. Journal of Revista Brasileira De Reumatologia. 2017;57(4):356-63.

Prados G, Miro E, Martinez MP, Sanchez AI, Lopez S, Saez G. Fibromyalgia: gender differences and sleep-disordered breathing. Journal of Clinical Experimental Rheumatologi. 2013;31(Suppl 79):S102-10.

D’Agnelli S, Arendt-Nielsen L, Gerra MC, Zatorri K, Boggiani L, Baciarello M, Bignami E. Fibromyalgia: genetics and epigenetics insights may provide the basis for the development of diagnostic biomarkers. Journal of Molecular Pain. 2019;15:1-12.

Hauser W, Thieme K, Turk DC. Guidelines on the management of fibromyalgia syndrome – a systematic review. European Journal Pain. 2010;14(1):5-10.

Thieme K, Flor H, Turk DC. Psychological pain treatment in fibromyalgia syndrome: efficacy of operant behavioural and cognitive behavioural treatments. Journal Arthritis research and Therapy. 2010;8(4):1-12.

Butler AC, Chapman JE, Forman EM, Beck AT. The emipirical status of cognitive-behavioral therapy: a review of meta-analyses. Journal of Clinical Psychology Review. 2012;26(1):17-31.

Scholz J, Finnerup NB, Attal N, Aziz Q, Baron R, Bannett MI, Dkk. The IASP classification of chronic pain for ICD-11: chronic neuropathic pain. Journal of Pain. 2019;160(1):53-9.

Mills SE, Nicolson KP, Smith BH. Chronic pain: a review of it’s epidemiology and associated factors in population-based studies. British Journal of Anaeshesia. 2019;123(2):273-83.

Vos T, Abajobir AA, Abbafati C, Abbas KM, Abate KH, Abdulle AM, Dkk. Global, regional and national incidence, prevalence and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the global burden of disease study 2016. Lancet. 2017;390:1211-59.

Fillingim RB, Loeser JD, Baron R, Edwards RR. Assessment of chronic pain: domain, methods and mechanism. Journal of Pain. 2016;17(Suppl 9):T10-T20.

Kaltsas G, Tsiveriotis K. Fibromyalgia [internet]. South Dartmouth; 2000 [diperbarui tanggal 14 Januari 2020; disitasi tanggal 5 Februari 2021]. Tersedia dari:

Wolfe F. The status of criteria. Journal of Arthritis and Rheumatology. 2015;67(2):330-3.

Theoharides TC, Tsilioni I, Arbetman L, Panagiotidou S, Stewart JM, Gleason RM, Dkk. Fibromyalgia syndrome in need of effective treatments. Journal of Pharmacology and Experimental Therapeutics. 2015;355:255-63.

Banfi G, Diani M, Pigatto PD, Reali E. T cell subpopulations in the physiopathology of fibromyalgia: evidence and perspectives. Journal of Molecular Sciences. 2020;21:1-13.

Bote ME, Garcia JJ, Hinchado MD, Ortega E. Inflammatory or stress feedback dysregulation in women with fibromyalgia. Journal of Neuroimmunomodulation. 2012;19:343-51.

Kadetoff D, Lampa J, Westman M, Andersson M, Kosek E. Evidence of central inflammation in fibromyalgia-increased cerebrospinal fluid interleukin-8 levels. Journal of Neuroimmunology. 2012;242:33-8.

Pernambuco AP, Schetino LP, Alvim CC, Murad CM, Viana RS, Carvalho LS, Reis DA. Increased levels of IL-17A in patients with fibromyalgia. Journal of Clinical Experimental Rheumatology. 2013;31(Suppl 79):S60-S3.

Bellato E, Marini E, Castoldi F, Barbasetti N, Mattei L, Bonasia DE, Dkk. Fibromyalgia syndrome: etiology, pathogenesis, diagnosis and treatment. Journal of Pain Research and Treatment. 2012;2012:1-17.

Totsch SK, Sorge RE. Immune system involvement in specific pain conditions. Journal of Molecular Pain. 2017;13:1-17.

Smith OC, Nicol AL, Christianson JA. Potential mechanism underlying centralized pain and emerging therapeutic interventions. Journal of Frontiers in Cellular Neuroscience. 2018;12(35):1-18.

Bote ME, Garcia JJ, Hinchado MD, Ortega E. Fibromyalgia: anti-inflammatory and stress responses after acute moderate exercise. Journal Plos One. 2013;8(9):1-6.

Tsilioni I, Russell IJ, Stewart JM, Gleason RM, Theoharides TC. Neuropeptides CRH, SP, HK-1, and Inflammatory Ctyokines IL-6 and TNF are increased in serum of patients with fibromyalgia syndrome, implicating mast cells. Journal of Pharmacology Experiment Therapeutic. 2016;356:664-72.

Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, Dkk. Chronic pain as a symptom or a disease: the IASP classification of chronic pain for the International Classification of Diseases (ICD-11). Journal of Pain. 2019;160(1):19-27.

Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Dkk. The American college of rheumatology 1990 criteria for the classification of fibromyalgia. Journal of Arthritis and Rheumatology. 1990;33(2):160-72.

Wolfe F, Walitt BT, Hauser W. What is fibromyalgia, how is it diagnosed, and what does it really mean? Journal of Arthritis Care and Research. 2014;66(7):969-71.

Wolfe F, Claw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, Dkk. The American college of rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Journal of Arthritis and Rheumatology. 2010;62(5):600-10.

Egloff N, Kanel RV, Muller V, Egle UT, Kokinogenis G, Stauber S, Dkk. Implications of proposed fibromyalgia criteria across othe functional pain syndrome. Journal of Scandinavian of Rheumatology. 2015;44(5):416-24.

Wolfe F, Egloff N, Hause W. Widespread pain and low widespread pain index scores among fibromyalgia-positive cases assessed with the 2010/2011 fibromyalgia criteria. Journal of Rheumatology. 2016;43(9):1743-48.

Arnold LM, Bennett RM, Croffor LJ, Dean LE, Clauw DJ, Goldenberg DL. AAPT diagnostic criteria for fibromyalgia. Journal of Pain. 2019;20(6):611-28.

Sanches CM, Reyes del Paso GA. Diagnostic criteria for fibromyalgia: critical review and future perspectives. Journal of Clinical Medicine. 2020;9:1-16.

Mohabbat AB, Mahapatra S, Jenkins SM, Bauer BA, Vincent A, Wahner DL. Use of complementary and integrative therapies by fibromyalgia patients: a 14-year follow-up study. Journal of Mayo Clinic Proceedings: Innovations, Quality and Outcomes. 2019;3(4):418-28.

Bidari A, Moazen ZE, Ghavidel PB, Rahmani S, Hosseini S, Hassankhani A. Comparing duloxetine and pregabalin for treatment of pain and depression in women with fibromyalgia: an open-label randomized clinical trial. Journal of Daru. 2019;27(1):149-58.

Moldofsky H, Harris HW, Archambault WT, Kwong T, Lederman S. Effects of bedtime very low dose cyclobenzaprine on symptoms and sleep physiology in patients with fibromyalgia syndrome: a double-blind randomized placebo controlled study. Journal Rheumatology. 2011;38:2653-63.

Schweiger V, Martini A, Bellamoli P, Donadello K, Schievano C, Balzo GD, Dkk. Ultramicronized palmitoylethanolamide (um-PEA) as add-on treatment in fibromyalgia syndrome (FMS): retrospective observational study on 407 patients. Journal of CNS Neuronal Disorder Drug Targets. 2019;18:326-33.

Macfarlane G, Kronisch C, Dean LE, Atzeni F, Hauser W, Kosek E, Dkk. EULAR revised recommendations for the management of fibromyalgia. Journal Polish Archieves of Internal Medicine. 2017;127(1):47-56.

Derry S, Wiffen PJ, Hauser W, Mucke M, Tolle TR, Bell RF, Dkk. Oral nonsteroid anti-inflammatory drugs for fibromyalgia in adults (review). Cochrane Database Systematic Review. 2017;3:1-74.

Petzke F, Bruckle W, Eidmann U, Heldmann P, Kollner V, Schiltenwolf M, Dkk. [General treatment principles, coordination of care and patient education in fibromyalgia syndrome: updated guidelines 2017 and overview of systematic review articles]. Schwerpunkt. 2017;31(3):246-54.

Pagliali G, Giangrandi I, Dinu M, Sofi F, Colombini B. Nutritional interventions in the management of fibromyalgia syndrome. Journal of Nutrients. 2020;12(9):1-19.

Ulatowski LM, Manor D. Vitamin E and neurodegeneration. Journal of Neurobiology of Disease. 2015;84:78-83.

Bjorklund G, Dadar M, Chirumbolo S, Aaseth J. Fibromyalgia and nutrition: therapeutic possibilities?. Journal of Biomedicine and Pharmacotherapy. 2018;103:531-38.

Minerbi A, Fitzcharle MA. Gut microbiome: pertinence in fibromyalgia. Journal of Clinical Experimental Rheumatology. 2020;38(Suppl 123):99-104.

Roman P, Estevez AF, Miras A, Sanchez-Labraca N, Canadas F, Vivas AB, Dkk. A pilot randomized controlled trial to explore cognitive and emotional effects of probiotics in fibromyalgia. Journal of Scientific Reports. 2018;8:1-9.

Affaitati G, Costantini R, Fabrizio A, Lapenna D, Tafuri E, Giamberardino MA. Effects of treatment of peripheral pain generators in fibromyalgia patients. European Journal of Pain. 2011;15(1):61-9.

Montero-Marin J, Rodriguez LA, Tops M, Garcia-Campayo J, Feliu-Soler A, Luciano JV, Dkk. Effects of attachment-based compassion therapy (ABCT) on brain-derived neutrophic factor and low-grade inflammation among fibromyalgia patients: a randomized controlled trial. Scientific Reports. 2019;9:1-14.

Norouzi E, Hosseini F, Vaezmosavi M, Gerber M, Puhse U, Brand S. Zumba dancing and aerobic exercise can improve working memory, motor function and depressive symptoms in female patients with fibromyalgia. European Journal Sport Scientific. 2020;20(7):981-91

Fonseca AC, Faria PC, Pinto WD, De Carvalho LG, Lopes FG. Effects of aquatic physiotherapy or health education program in women with fibromyalgia: a randomized clinical trial. Journal of Physiotherapy Theory Practice. 2019;15:1-13.

Eroksuz R, Forestier FB, Karaaslan F, Forestier R, Erdogan N, Donmez A. Dkk. Comparison of intermittent and consecutive balneological outpatient treatment (hydrotherapy and peloidotherapy) in fibromyalgia syndrome: a randomized, slnlge-blind, pilot study. 2020;64(3):513-20.

Jablochkova A, Kosek E, Mannerkorpi K, Ernberg M, Gerdle B, Ghafouri B. Unaltered low nerve growth factor and high brain-derived neurotrophic factor levels in plasma from patients with fibromyalgia after a 15-weeks progressive resistance exercise. Journal of Rehabilitation Medicine. 2019;51(10):779-87.



How to Cite

Maula Al Farisi, Muhartono, Anggi Setiorini, & M. Praditia Ansor. (2021). Fibromyalgia: Literature Review. Medical Profession Journal of Lampung, 11(1), 63-76.




Most read articles by the same author(s)