Fibromyalgia Syndrome and Myofascial Pain Syndromes

Rheumatic pain is prevalent, increases with aging and impacts on well-being. Management begins with an accurate identification and location of the complaint as being either an inflammatory or degenerative process in the joint, or pathology in the soft tissue structures. Pain management should occur in parallel with best care of the underlying rheumatic process, and should include both nonpharmacological as well as pharmacologic strategies. New knowledge invokes both nociceptive as well as neuropathic mechanisms in the generation of rheumatic pain, thereby broadening the range of pharmacologic treatment options. Outcome should be focused on improved function as well as pain relief, with careful attention to the balance of therapeutic benefit and adverse effect of treatment.