Recommendations by the Spanish Society of Rheumatology on Fibromyalgia. Part 1: Diagnosis and Treatment

Reumatol Clin (Engl Ed). 2021 Apr 27:S1699-258X(21)00058-9. doi: 10.1016/j.reuma.2021.02.004. Online ahead of print.
[Article in English, Spanish]

Abstract

Objective: To prevent the impairment of fibromyalgia patients due to harmful actions in daily clinical practice that are potentially avoidable.

Methods: A multidisciplinary team identified the main areas of interest and carried out an analysis of scientific evidence and established recommendations based on the evidence and "formal evaluation" or "reasoned judgment" qualitative analysis techniques.

Results: A total of 39 recommendations address diagnosis, unsafe or ineffective treatment interventions and patient and healthcare workers' education. This part I shows the first 27 recommendations on the first 2 areas.

Conclusions: Establishing a diagnosis improves the patient's coping with the disease and reduces healthcare costs. NSAIDs, strong opioids and benzodiazepines should be avoided due to side effects. There is no good evidence to justify the association of several drugs. There is also no good evidence to recommend any complementary medicine. Surgeries show a greater number of complications and a lower degree of patient satisfaction and therefore should be avoided if the surgical indication is not clearly established.

Keywords: Fibromialgia; Fibromyalgia; Recomendaciones; Recommendations; Sociedad Española de Reumatología; Spanish Society of Rheumatology.