Title:A Historical and Clinical Perspective Endorsing Person-centered Management of Fibromyalgia Syndrome
VOLUME: 11 ISSUE: 2
Author(s):Alfonse T. Masi and Ann Vincent
Affiliation:Department of Medicine, University of Illinois College of Medicine at Peoria, One Illini Drive, Box 1649, Peoria, Illinois 61656.
Keywords:Biopsychosocial model, fibromyalgia syndrome, fibrositis, patient-centered, person-centered.
Abstract:Fibromyalgia or fibromyalgia syndrome (FMS) is a complex chronic pain disorder of unknown
causation frequently associated with debilitating fatigue, unrefreshing sleep, cognitive and affective
symptoms. A fibromyalgia-type suffering was possibly described in the Book of Job. Analogous
symptomatic conditions have been medically recognized since the early 1900s, when initially labeled
as “fibrositis”. Since the early 1980s, FMS has evolved and differentiated after its characterization
in a controlled study. Since then, research has focused on multiple aspects of this disorder, including
characterization and management of symptoms, psychophysiology, neuroendocrine-immune
pathophysiology, including central sensitization mechanisms. The complex and multifaceted nature of FMS lends itself
better to a holistic (integrative medicine) or biopsychosocial approach than the more specific bioscientific pathways typical
for a pathologically-defined disease.
A person-centered approach to evaluation and care more effectively addresses and encompasses the biopsychosocial aspects
of this disorder than traditional bioscientific clinical methods. This review outlines a holistic multi-modal, patientcentered
approach to evaluation and care as a framework for primary clinic settings. Future directions in research, diagnosis,
and management of fibromyalgia patients should incorporate revised person-centered and other qualitative models of
care for critical comparison to current conventional concepts and clinical practice. The more comprehensive personcentered
services need to be compared to the current standardized practice in terms of their cost-effective outcomes, patient
satisfaction, physician gratification, and practical logistics of providing long-term follow up and management.
