Activity 7: Fibromyalgia in Family Medicine: Challenges in Pain Management

CME certification of this program has expired. The program is still available for viewing, but is no longer eligible for CME credit.

Program Overview

Managing the pain component of fibromyalgia is challenging and frustrating for the family physician for many reasons.1 In particular, fibromyalgia pain is often refractory to standard clinical interventions, and physicians need to deal with misconceptions surrounding the disease.2 This activity aims to overcome these practice barriers by putting the growing body of evidence-based guidelines into clinical context and by providing a clear strategy for the management of pain associated with fibromyalgia.

During this program, faculty will address misconceptions surrounding fibromyalgia and describe the latest data regarding the pathophysiology of the disease. A practical strategy for diagnosis of the condition in family medicine will be provided, together with a step-wise approach to pharmacologic therapy. Faculty will also emphasize the impact of comorbid conditions on the choice of treatments and explain the importance of screening for these conditions. Finally, the role of nonpharmacologic management approaches will be described, together with the value of combining such strategies with pharmacologic agents. Emphasis will be placed upon the need for individualized patient plans and the value of an empathetic and well-informed health care provider. Throughout the activity, faculty will review available tools and resources that can be used to assist the family physician in the management of pain associated with fibromyalgia.

  1. Huynh C, Yanni L, Morgan L. Key practice points in the management of fibromyalgia. Am Fam Physician 2007; 76(2): 195-202
  2. Improving patient outcomes in fibromyalgia. Available at

Intended Audience

This continuing medical education program is intended for family practitioners and other healthcare professionals who manage patients with fibromyalgia.

Learning Objectives

After completing this activity, participants will be better able to:

  • Evaluate emerging data regarding the pathophysiology of fibromyalgia
  • Review the recommended pharmacologic and nonpharmacologic treatments for fibromyalgia pain including newer developments
  • Tailor treatment of pain to address common comorbidities associated with fibromyalgia such as depression, fatigue, and sleep disturbance
  • Describe the role of multimodal treatment strategies for fibromyalgia pain
  • Formulate realistic treatment goals and educate patients about the expected outcomes of treatments for pain associated with fibromyalgia
  • Discuss approaches to monitoring treatment response, managing adverse effects, and optimizing outcomes
  • Discuss the importance of the patient-physician partnership in the management of fibromyalgia pain
  • Discuss the importance of patient education in the management of fibromyalgia pain
  • Discuss misconceptions regarding fibromyalgia


Dawn A. Marcus, MD
University of Pittsburgh Medical Center
Pittsburgh, PA

Amy Clouse, MD
Associate Director
Abington Family Medicine
Jenkintown, PA

Editorial Team

Leigh McKinney
Project Manager
American Academy of Family Physicians

Sian Sumner
Content Manager
MedEd Architects, LLC

AAFP Contact

Susanna Guzman
Director, Online and Custom Publishing
American Academy of Family Physicians

CME Accreditation

This activity, Fibromyalgia in Family Medicine: Challenges in Pain Management, has been reviewed and is acceptable for up to 1 Prescribed credit(s) by the American Academy of Family Physicians. This credit conforms to the AAFP criteria for evidence-based CME clinical content. AAFP accreditation begins September 15, 2010. Term of approval is for 2 year(s) from this date with the option of yearly renewal. When reporting AAFP credit, claim total Prescribed and Elective credit for this activity. It is not necessary to label credit as evidence-based CME for reporting purposes.

The EB CME credit awarded for this activity was based on practice recommendations that were the most current with the strongest level of evidence available at the time this activity was approved. Since some clinical research is ongoing, the American Academy of Family Physicians recommends that learners verify sources and review these and other recommendations prior to implementation into practice.

The AAFP is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Academy of Family Physicians designates this education activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.


Introduction and Opening Remarks
Module 1: Challenges in Fibromyalgia: Diagnosis and Attitudes
Module 2: Pharmacologic Management of Pain Associated with Fibromyalgia
Module 3: Case Studies: Best Practices in Fibromyalgia Pain Management
Module 4: Multimodal Management of Pain Associated with Fibromyalgia
Closing Remarks


It is the policy of the AAFP that all CME planning committee/faculty/authors/editors/staff disclose relationships with commercial entities upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest and, if identified, they are resolved prior to confirmation of participation. Only these participants who have no conflict of interest or who agree to an identified resolution process prior to their participation were involved in this CME activity.

The AAFP and MedEd Architects staffs have indicated that they have no relationships to disclose relating to the subject matter of the activity. Drs. Marcus and Clouse have returned a disclosure form indicating that they have no financial interest in or affiliation with any commercial supporter or providers of any commercial services discussed in this educational material.

This program is supported by an educational grant from Pfizer Inc.

Note About Medications and Off-label Uses

The faculty for this activity have made all reasonable efforts to ensure that information contained herein is accurate in accordance with the latest available scientific knowledge at the time of accreditation. Information regarding medications (e.g., administration, dosages, contraindications, adverse reactions, interactions, special warnings, and precautions) and delivery systems is subject to change; and the reader is advised to check the manufacturer's insert and medical references for information concerning recommended dosage and potential problems or cautions prior to dispensing or administering any medication.

The faculty will discuss common but off-label uses of medications in this activity. See the list of medications discussed in the Downloadable Resources section.


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