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Fibromyalgia in Older Individuals

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Abstract

Fibromyalgia (FM) is a condition of chronic widespread pain (CWP) that can occur throughout the life cycle and is likely underrecognized in older patients. FM is associated with considerable suffering and reduction in quality of life and may occur as a unique condition, but in older patients is most likely to be associated with another medical illness. Understood mechanistically to be a sensitization of the nervous system, recently identified as nociplastic pain, FM is accepted as a valid medical illness that requires a positive diagnosis and directed treatments. The cornerstone of treatments for FM are nonpharmacologic interventions, with the understanding that medications provide only modest benefit for most patients, and with particular concern about adverse effects in older patients. If FM is not recognized, treatments may be misdirected to the other medical condition, with failure to address FM symptoms, leading to overall poor outcome. In contrast, new complaints in older patients should not immediately be attributed to FM, and physicians should be vigilant to ensure that onset of a new illness is not ignored. As FM is most often a lifelong condition, patients should be encouraged to identify their own personal strategies that can attenuate symptoms, especially when symptoms flare. Continued life participation should be the outcome goal.

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Authors and Affiliations

  1. Institute for Pain Medicine, Rambam Health Campus, Haifa, Israel

    Amir Minerbi

  2. Ruth and Bruce Rapaport Faculty of Medicine, Technion, Haifa, Israel

    Amir Minerbi

  3. Alan Edwards Pain Management Unit, McGill University Health Centre, Montreal General Hospital, 1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada

    Mary-Ann Fitzcharles

  4. Division of Rheumatology, McGill University Health Centre, Montreal, QC, Canada

    Mary-Ann Fitzcharles

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  1. Amir Minerbi
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  2. Mary-Ann Fitzcharles
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Correspondence to Mary-Ann Fitzcharles.

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Minerbi, A., Fitzcharles, MA. Fibromyalgia in Older Individuals. Drugs Aging 38, 735–749 (2021). https://doi.org/10.1007/s40266-021-00879-x

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