Current pharmacological management, treatment challenges, and potential future treatment options for fibromyalgia syndrome.

INTRODUCTION: Fibromyalgia (FMS), or Fibro-Myalgia Syndrome, is a complex disorder characterized by pain, fatigue and impaired quality of life. FMS will affect a patient's functionality and often lead to significant disability. FMS remains underdiagnosed and undertreated and is an important comorbidity in patients with musculoskeletal disease. The optimal management of FMS is hindered due to the limited evidence base for treatments. The chronic nature of FMS means increased healthcare costs and an economic burden.

AREAS COVERED: We searched articles from Cochrane reviews and PubMed with a focus on treatments in FMS. Research continues to focus on central sensitization, peripheral sensitization, and inflammatory dysfunction. Objective diagnosis remains difficult due to lack of biomarkers. Current pharmacological options include drugs like Pregabalin, Duloxetine, and Milnacipran, alongside off-label therapies and emerging treatments such as antivirals and cannabinoids.

EXPERT OPINION: FMS is not a diagnosis of exclusion and diagnosis of FMS can allow a patient's distress to be explained and understood. Though no cure exists for FMS management strategies have been shown to improve patients' symptoms and quality of life.