Type your tag names separated by a space and hit enter

Fibromyalgia treatment guidelines from EULAR


Clinical Question:
What are the preferred approaches to treating patients with fibromyalgia?

Bottom Line:
Antidepressants, pramipexole (Mirapex and Sifrol), pregabalin (Lyrica), tramadol (Ultram), tropisetron (Navoban), and heated pool treatments have been shown to have short-term effectiveness in the treatment of fibromyalgia pain. (LOE = 1a-)

Carville SF, Arendt-Nielsen S, Bliddal H, et al. EULAR evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis 2008;7:536-541.  [PMID:17644548]

These guidelines were developed by EULAR, a multidisciplinary task force of representatives from 11 European countries. To prepare this guideline, the group performed a comprehensive search and evaluation of the available medical literature, using a consensus system. Strong evidence was available only for drug therapy. Based on a good response in several small trials, the group recommends heated pool treatments with or without exercise (strength of evidence: B). Tramadol, antidepressants, tropisetron, pramipexole, and pregabalin are effective for reducing pain, and antidepressants can improve function (strength of evidence: A). There is only weak evidence supporting the use of tailored exercise programs, cognitive behavioral therapy, acetaminophen, or weak opioids. The group recommends against the use of corticosteroids or strong opioids. No research has evaluated the relative benefits of treatment, and most of the studies are short in duration, creating the possibility of a potent placebo effect.

Fibromyalgia treatment guidelines from EULAR is a sample topic from the EE+ POEM Archive.

To view other topics, please or purchase a subscription.

Evidence Central is an integrated web and mobile solution that helps clinicians quickly answer etiology, diagnosis, treatment, and prognosis questions using the latest evidence-based research. Learn more.


Slawson, David C., et al., editors. "Fibromyalgia Treatment Guidelines From EULAR." EE+ POEM Archive, John Wiley & Sons, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/infoPOEMs/426108/all/Fibromyalgia_treatment_guidelines_from_EULAR.
Fibromyalgia treatment guidelines from EULAR. In: Slawson DC, Shaughnessy AF, Ebell MH, et al, eds. EE+ POEM Archive. John Wiley & Sons; 2019. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426108/all/Fibromyalgia_treatment_guidelines_from_EULAR. Accessed May 21, 2019.
Fibromyalgia treatment guidelines from EULAR. (2019). In Slawson, D. C., Shaughnessy, A. F., Ebell, M. H., & Barry, H. (Eds.), EE+ POEM Archive. Available from https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426108/all/Fibromyalgia_treatment_guidelines_from_EULAR
Fibromyalgia Treatment Guidelines From EULAR [Internet]. In: Slawson DC, Shaughnessy AF, Ebell MH, Barry H, editors. EE+ POEM Archive. John Wiley & Sons; 2019. [cited 2019 May 21]. Available from: https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426108/all/Fibromyalgia_treatment_guidelines_from_EULAR.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Fibromyalgia treatment guidelines from EULAR ID - 426108 ED - Slawson,David C, ED - Shaughnessy,Allen F, ED - Ebell,Mark H, ED - Barry,Henry, BT - EE+ POEM Archive UR - https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426108/all/Fibromyalgia_treatment_guidelines_from_EULAR PB - John Wiley & Sons DB - Evidence Central DP - Unbound Medicine ER -