© Springer International Publishing Switzerland 2016 175
Y. El Miedany (ed.), Patient Reported Outcome Measures in Rheumatic Diseases,
DOI 10.1007/978-3-319-32851-5_7
Chapter 7
PROMs for Fibromyalgia
Loreto Carmona , Rafael J. Curbelo , and Concepción González Isabel
Introduction
Etymologically, the term “ fi bromyalgia ” means pain in the muscle fi bers, and was
fi rst used by Hench in 1976 [ 1 ]. In 1904, Gowers had named it “fi brositis” [ 2 ]; how-
ever, as peripheral infl ammation has never been proven since, the suffi x – itis was not
established. The “Fibromyalgia syndrome” (FMS) was accepted by the World Health
Organization (WHO) in 1992, with the code M79.7 of the International Classifi cation
of Diseases (ICD-10), as a nonarticular rheumatism [ 3 ]. Clinically, it is defi ned as
“pain in the muscles, ligaments, and tendons,” i.e., fi brous parts of the body.
According to the 1990 classifi cation criteria of the American College of
Rheumatology (ACR), FMS is characterized by the existence of widespread musculo-
skeletal pain, of unknown etiology, lasting for at least 3 months, with pain in no less
than 11 out of 18 pressure points—also known as tender or trigger points [ 4 ]. However,
in addition to increased sensitivity to pain, FMS may also cause stiffness, fatigue, cog-
nitive impairment, paresthesia, bloating, hand swelling, and low-quality sleep, among
other somatic symptoms, and in some patients other conditions exist concomitantly,
such as irritable bowel syndrome, tension headaches with subsequent dominance,
Raynaud’s phenomenon, or temporomandibular joint pathology. That is the reason
why in 2010 a new classifi cation was proposed, including pain plus other symptoms
[ 5 ]. These new criteria classify a patient with FMS if either high level of pain plus
L. Carmona , M.D., Ph.D. (*) • R. J. Curbelo , M.Sc., Ph.D.
Instituto de Salud Musculoesquelética , Calle Conde de la Cimera, 6 , Madrid 28040 , Spain
e-mail: [email protected]; [email protected]
C. G. Isabel , Ph.D.
Instituto de Salud Osteoarticular , Conde de la Cimera 6 , Madrid 28040 , Spain
e-mail: [email protected]