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Easily tired
Joint stiffness
Low back pain
Left arm pain
Leg pain
Body aches
Lower back pain and extreme tiredness
Body aches no fever
Forearm pain
Fatigue in morning
Insomnia
Not seeing your symptoms? No worries!
A condition causing widespread pain and muscle aches throughout the body that may come and go with certain identified triggers. The cause is not well understood.
Your doctor may ask these questions to check for this disease:
Treatment is multimodal and not curative. It includes a variety of things like medications, therapy, stress reduction techniques and exercise to help alleviate symptoms.
Reviewed By:
Kenji Taylor, MD, MSc (Family Medicine, Primary Care)
Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.
Kaito Nakamura, MD (Rheumatology)
Dr. Nakamura is a rheumatologist who has practiced in the Ota Nishinouchi Hospital attached to Ota General Hospital, National Health Insurance Matsudo City Hospital, Chiba University Hospital, and the National Health Insurance Asahi Central Hospital.
Content updated on Nov 15, 2024
Following the Medical Content Editorial Policy
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I have been diagnosed with Ehlers-Danlos Syndrome, but recently have been thinking I have something that needs more intensive and direct treatment, like Multiple Sclerosis. Ubie suggested that I look at a couple different possible conditions, and I REALLY appreciated how detailed it was! I loved that I could add specifics and that it asked me to follow up on symptoms with more clarification. It genuinely feels like the people who developed Ubie care about helping people find the right resources and information to get an accurate diagnosis and find proper care. No other website has compared to my experience with Ubie, and as someone with a chronic disability, I have had an exorbitant amount of experience. The fact that this was all free was beyond my belief. I am amazed and grateful.
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Q.
Silent Agony? Why Your Nerves are Misfiring & Medical Fibromyalgia Steps
A.
Widespread pain with normal tests may be fibromyalgia, a nervous system disorder driven by central sensitization that turns up pain signaling and often brings fatigue, unrefreshing sleep, and brain fog. Diagnosis is clinical after other diseases are excluded, and care focuses on calming the system with options like duloxetine or milnacipran, pregabalin, gentle exercise, sleep optimization, CBT, and stress reduction while avoiding opioids. There are several factors to consider, including red flags and step by step next actions, so see the complete guidance below to choose the best path forward.
References:
* Roldan-Mercado NF, Galindo-Arellano K, Rosas-Aguirre A, Valadez-García F, Torres-Carrillo NA. Neuropathic Pain Features in Fibromyalgia: A Systematic Review. Pain Physician. 2020 May;23(3):E237-E246. PMID: 32460655.
* Li R, Zhang Y, Wang Y, Song T. Small fiber neuropathy in fibromyalgia: A systematic review and meta-analysis. Joint Bone Spine. 2023 Mar;90(2):105470. doi: 10.1016/j.jbspin.2022.105470. Epub 2022 Nov 10. PMID: 36395568.
* Lim MMH, Voon SR, Koh SKD. Central Sensitization: The Convergence of Stress and Pain in Fibromyalgia. Pain Res Manag. 2022 Aug 18;2022:3615967. doi: 10.1155/2022/3615967. PMID: 36060136; PMCID: PMC9422838.
* Siracusa MS, Siracusa ST, Siracusa NT, Siracusa AT. Fibromyalgia: Current Perspectives on Pathophysiology, Diagnosis, and Treatment. J Clin Med. 2020 Nov 6;9(11):3542. doi: 10.3390/jcm9113542. PMID: 33171887; PMCID: PMC7694584.
* Roldan-Mercado NF, Torres-Carrillo NA, Valadez-García F, Galindo-Arellano K, Rosas-Aguirre A. The role of neuroinflammation in fibromyalgia: a systematic review of the literature. Pain Physician. 2022 Jul;25(4):E433-E446. PMID: 35921477.
Q.
Why Your Body Feels Like It’s Fraying? Ehlers-Danlos Syndrome (EDS) & Medically Approved Next Steps
A.
Ehlers-Danlos syndrome can make your body feel like it is fraying because faulty collagen weakens connective tissue, leading to joint hypermobility, fragile or stretchy skin, chronic pain and fatigue, and in some types such as vascular EDS, serious risks to blood vessels or organs. Medically approved next steps include documenting symptoms, asking for a joint hypermobility assessment and targeted referrals, starting hypermobility‑smart physical therapy while protecting joints and managing pain safely, and knowing red flags that require urgent care. There are several important factors to consider, including overlaps with other conditions and differences by EDS type, so see below for details that could change the right next steps for you.
References:
* Malfait F, Francomano R, Byers P, Belmont J, Berglund B, BORSUM-OTTENHEIMER F, et al. The 2017 international classification of the Ehlers-Danlos syndromes. Am J Med Genet C Semin Med Genet. 2017 Mar;175(1):8-26. doi: 10.1002/ajmg.c.31552. Epub 2017 Feb 20. PMID: 28306229.
* Tinkle B, Castori M, Berglund B, Cohen H, Driver CC, Francomano C, et al. Hypermobile Ehlers-Danlos Syndrome (hEDS): Clinical Description and Natural History. Am J Med Genet C Semin Med Genet. 2017 Mar;175(1):48-69. doi: 10.1002/ajmg.c.31538. Epub 2017 Feb 20. PMID: 28306227.
* Chopra P, Tinkle B, Hamonet C, Brock I, Gompel A, Bulbena A, et al. Pain Management in the Ehlers-Danlos Syndromes: A Review. Am J Med Genet C Semin Med Genet. 2017 Mar;175(1):159-166. doi: 10.1002/ajmg.c.31554. Epub 2017 Feb 20. PMID: 28306232.
* Gillam E, Cleland C. Ehlers-Danlos syndrome: a diagnostic challenge. Br J Hosp Med (Lond). 2021 Apr 22;82(4):1-8. doi: 10.12968/hmed.2021.0116. PMID: 33878191.
* Patel M, Alshami A, Munk A, Palai P, Waisel A, Klemperer J, et al. A Scoping Review of Multidisciplinary Care for Ehlers-Danlos Syndromes. J Clin Rheumatol. 2023 Apr 1;29(3):e491-e497. doi: 10.1097/RHU.0000000000001928. Epub 2022 Dec 12. PMID: 36511559.
Q.
Wobbly After Weeping? The Emotional Trigger for Muscle Loss
A.
Feeling wobbly after crying is usually a short-lived muscle weakness from a post-adrenaline drop, breathing changes, and shifts in blood pressure or blood sugar rather than true muscle loss. There are several factors to consider; see more details below. If the weakness is sudden, clearly triggered by emotions and you remain aware, it could be cataplexy related to narcolepsy type 1 and worth medical evaluation; the full red flags, differentials, and practical next steps are outlined below.
References:
* Kim Y, et al. Chronic emotional stress causes muscle atrophy through the activation of glucocorticoid and IL-6 pathways in mice. *Psychoneuroendocrinology*. 2018 Jan;87:210-218. PMID: 29080789.
* Choi KM. The Role of Stress and Inflammation in Sarcopenia. *Int J Mol Sci*. 2021 Dec 22;23(1):E18. PMID: 35010640.
* Li Z, et al. Depression and Muscle Wasting: A Comprehensive Review. *Nutrients*. 2023 Jan 13;15(2):404. PMID: 36675204.
* Tan X, et al. Chronic stress leads to skeletal muscle atrophy in rats through impaired mitochondrial function and increased oxidative stress. *J Cachexia Sarcopenia Muscle*. 2022 Oct;13(5):2521-2533. PMID: 35307521.
* Vanden Bosch A, et al. Glucocorticoids and skeletal muscle: from myopathy to sarcopenia. *J Cachexia Sarcopenia Muscle*. 2017 Aug;8(4):534-547. PMID: 28424266.
Q.
Ehlers Danlos Syndrome: Symptoms in Women 30-45 & Next Steps
A.
In women 30 to 45, Ehlers Danlos Syndrome commonly shows up as joint hypermobility with instability, frequent sprains or dislocations, chronic widespread pain, fatigue and brain fog, soft or easily bruised skin, pelvic floor problems, and digestive issues, while certain subtypes like vascular EDS add red flags such as thin translucent skin, unusual bruising, or sudden severe chest or abdominal pain that require urgent care. Next steps include tracking symptoms and family history, requesting referrals to a knowledgeable specialist team and a stabilization focused physical therapist, considering cardiology when vascular risks are present, and using paced low impact activity, targeted pain strategies, and lifestyle supports, with hEDS diagnosed clinically and other types by genetic testing; there are several factors to consider, and key details that may affect your choices are explained below.
References:
* Ali A, et al. Ehlers-Danlos Syndromes: Clinical Manifestations, Diagnosis, and Management. *Adv Exp Med Biol*. 2023;1397:331-356. doi: 10.1007/978-3-031-31427-4_15. PMID: 37490236.
* Patel M, et al. Women's Reproductive Health and Hypermobile Ehlers-Danlos Syndrome. *Curr Rheumatol Rep*. 2023 Feb;25(2):29-37. doi: 10.1007/s11926-023-01083-4. PMID: 36720760.
* Castori M, et al. Ehlers-Danlos syndrome, hypermobility type: an update on the challenges and pitfalls. *Am J Med Genet C Semin Med Genet*. 2017 Mar;175(1):151-158. doi: 10.1002/ajmg.c.31551. PMID: 28387023.
* Scheper MC, et al. The multidisciplinary approach to Ehlers-Danlos syndrome. *Clin Exp Rheumatol*. 2021 May-Jun;39 Suppl 130:1-8. PMID: 33769188.
* Kohn N, et al. Postural Orthostatic Tachycardia Syndrome in the Ehlers-Danlos Syndromes. *J Cardiovasc Transl Res*. 2023 Oct;16(5):989-1002. doi: 10.1007/s12265-023-10427-0. PMID: 37490235.
Q.
Fibromyalgia in Women 30-45: Vital Symptoms & Your Action Plan
A.
For women 30 to 45, fibromyalgia most often presents as widespread pain lasting over three months on both sides of the body with profound fatigue, nonrestorative sleep, and fibro fog, often along with sensitivities, mood changes, headaches, IBS, and pelvic or menstrual pain. It is real and manageable, and the most effective action plan starts with seeing a clinician to confirm the diagnosis and rule out mimics, then focuses on better sleep, gentle consistent movement, active stress management, nutrition, support, and medications when needed; there are several factors to consider, so see the complete guidance below to choose your next steps. Seek urgent care for chest pain, shortness of breath, high fever, sudden severe weakness, unexplained weight loss, or new neurological symptoms.
References:
* Mease PJ, et al. Fibromyalgia in women: characteristics, diagnosis and treatment. Curr Rheumatol Rep. 2017 Nov 3;19(12):76. doi: 10.1007/s11926-017-0701-z. PMID: 29082352.
* Van de Casteele M, et al. Clinical characteristics of fibromyalgia in young women: a systematic review. Rheumatol Int. 2022 Mar;42(3):369-382. doi: 10.1007/s00431-022-04533-0. Epub 2022 Feb 10. PMID: 35150893.
* Macfarlane GJ, et al. 2016 EULAR recommendations for the management of fibromyalgia. Ann Rheum Dis. 2017 Feb;76(2):318-328. doi: 10.1136/annrheumdis-2016-209724. Epub 2016 Oct 18. PMID: 27956328; PMCID: PMC5284566.
* Costa D, et al. Impact of fibromyalgia on daily living and quality of life in women: a qualitative study. Rev Bras Reumatol (Engl Ed). 2021 Mar-Apr;61(2):167-175. doi: 10.1016/j.rbre.2020.12.004. Epub 2021 Mar 12. PMID: 33735165; PMCID: PMC9283733.
* Bidari A, et al. Update on the pathophysiology and management of fibromyalgia. Curr Pain Headache Rep. 2020 Jan 2;24(1):2. doi: 10.1007/s11916-019-0834-5. PMID: 31804253.
Q.
Methocarbamol for Women: Relief, Safety & Essential Next Steps
A.
Methocarbamol can provide short-term relief of acute muscle spasms and pain in women by calming nerve signals, but it may cause drowsiness, interacts with alcohol and other sedating medicines, and should be used cautiously in pregnancy or breastfeeding and in people with liver or kidney disease, seizures, or myasthenia gravis. There are several factors to consider, especially if pain persists or is widespread, when you may need evaluation for underlying causes like fibromyalgia and guidance on safer use, alternatives such as physical therapy, and red flags that require urgent care; see the complete details and essential next steps below.
References:
* Banh LC, et al. Use of skeletal muscle relaxants during pregnancy. Drugs. 2011;71(1):5-10. doi: 10.2165/11585290-000000000-00000. PMID: 21190457.
* See S, et al. Methocarbamol for acute low back pain: a randomized, double-blind, placebo-controlled study. J Pain Res. 2012;5:223-31. doi: 10.2147/JPR.S32185. PMID: 22754297.
* Cagnin T, et al. Pharmacokinetics and Safety of Muscle Relaxants in Breastfeeding Women: A Systematic Review. J Clin Pharmacol. 2021;61(4):460-474. doi: 10.1002/jcph.1772. PMID: 33269418.
* See S, et al. Clinical Pharmacology and Therapeutics of Skeletal Muscle Relaxants. Drug Saf. 2008;31(1):63-80. doi: 10.2165/00002018-200831010-00005. PMID: 18190013.
* Oertelt-Prigione S. Sex differences in drug response: a review of selected muscle relaxants. Expert Rev Clin Pharmacol. 2020;13(9):983-991. doi: 10.1080/17512433.2020.1793132. PMID: 32662767.
Q.
Gua Sha for Women 65+: Natural Relief for Pain & Aging Skin
A.
Gua sha can offer women 65+ a gentle, low-cost way to ease neck and shoulder stiffness and tension headaches and to temporarily reduce facial puffiness and improve skin glow, when used with light pressure and oil. There are several factors to consider, including that benefits are short term and it does not treat arthritis or erase deep wrinkles; see below for evidence, safe how-to steps, and how it fits into a broader healthy aging plan. Safety matters and it is not right for everyone: avoid if you bruise easily, have bleeding disorders or clots, take blood thinners, have skin infections, or severe osteoporosis, and speak with a clinician about new or widespread pain or to explore possible fibromyalgia using the symptom checker linked below; it should not replace medical evaluation for serious symptoms.
References:
* Wang Y, Li M, Zhang Z, Tian H. The effect of Gua sha therapy on musculoskeletal pain: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Clin Pract. 2022 Nov;49:101689. doi: 10.1016/j.ctcp.2022.101689. Epub 2022 Aug 23. PMID: 36049281.
* Kim J, Cho M. Randomized Controlled Trial for the Effectiveness of Cosmetic Acupuncture and Gua Sha with Facial Lifting Massage on Facial Skin Elasticity. J Acupunct Meridian Stud. 2019 Aug;12(4):119-125. doi: 10.1016/j.jams.2019.06.002. Epub 2019 Jun 25. PMID: 31338661.
* Braun M, Schwickert M, Nielsen A, Brunnhuber S, Dobos G, Michalsen A, Musial F. Effectiveness of traditional Chinese "Gua Sha" therapy in patients with chronic neck pain: a randomized controlled trial. Pain Med. 2013 Nov;14(11):1624-33. doi: 10.1111/pme.12209. Epub 2013 Aug 30. PMID: 24510793.
* Nielsen A, Knoblauch NT, Dobos T, Michalsen R, K Vickers A. The effect of Gua sha on skin temperature and microcirculation: A randomized controlled trial. Explore (NY). 2012 Mar-Apr;8(2):99-106. doi: 10.1016/j.explore.2011.10.001. Epub 2012 Mar 15. PMID: 22420107.
* Schwickert M, Braun M, Nielsen A, Kober S, Michalsen A, Musial F. Gua Sha-Induced HO-1 Expression Modulates Microcirculation and Provides Cytoprotection: Molecular and Microcirculatory Characterization of an Anti-inflammatory Intervention. Evid Based Complement Alternat Med. 2014;2014:130107. doi: 10.1155/2014/130107. Epub 2014 Dec 21. PMID: 25556213; PMCID: PMC4279093.
Q.
Is It Aging or Fibromyalgia? 7 Signs & Relief for Women 65+
A.
For women 65+, fibromyalgia goes beyond typical aging when pain is widespread on both sides for at least 3 months and may move around, paired with unrefreshing sleep, severe fatigue, brain fog, and heightened sensitivity despite normal test results. There are several factors to consider, see below to understand more. Relief is possible through a personalized plan that can include doctor‑guided medications and sleep care, gentle movement, stress and sleep strategies, and supportive nutrition, and the complete guidance below also notes red flags, symptom tracking, a free symptom check, and when to speak to a doctor.
References:
* Clauw DJ, et al. Fibromyalgia in the Elderly: A Narrative Review. Pain Ther. 2020 Dec;9(6):957-967. doi: 10.1007/s40122-020-00204-6. Epub 2020 Aug 21. PMID: 32822838; PMCID: PMC7704519.
* Salafia F, et al. Differential diagnosis of fibromyalgia syndrome in the elderly: a narrative review. Expert Rev Neurother. 2021 Oct;21(10):1157-1165. doi: 10.1080/14737175.2021.1958614. Epub 2021 Jul 22. PMID: 34293818.
* Loo C, et al. Management of Fibromyalgia in Older Adults. Curr Pain Headache Rep. 2023 Feb;27(2):1-10. doi: 10.1007/s11916-023-01083-0. Epub 2023 Jan 19. PMID: 36676356.
* Cho Y, et al. Prevalence, Clinical Features, and Management of Fibromyalgia in the Elderly: A Literature Review. Pain Physician. 2018 Jan;21(1):15-22. PMID: 29329060.
* Fares H, et al. Fibromyalgia in older adults: diagnostic challenges and therapeutic considerations. Aging Clin Exp Res. 2019 Aug;31(8):1075-1083. doi: 10.1007/s40520-019-01111-w. Epub 2019 Jan 23. PMID: 30673070.
Q.
Fibromyalgia in Women: Overcoming Chronic Pain & Fatigue
A.
Fibromyalgia is a real, long-term, not life threatening condition that affects women more often, causing widespread pain, deep fatigue, unrefreshing sleep, and fibro fog due to increased pain sensitivity in the nervous system, not damage to muscles or joints. Meaningful relief usually comes from a combined plan of tailored medications, gentle regular movement with pacing, consistent sleep routines, and stress and mood support, and the full guidance on diagnosis, triggers, red flags, and when to see a doctor is outlined below to help you choose the right next steps.
References:
* Clauw, D. J., & Crofford, L. J. (2020). Fibromyalgia in women: characteristics and management. *Womens Health (Lond)*, *16*, 1745506520921443. doi:10.1177/1745506520921443
* Marcus, D. A., & Scharff, L. (2018). Sex Differences in Fibromyalgia: A Focus on Pain and Psychological Symptoms. *Pain Res Manag*, *2018*, 9363847. doi:10.1155/2018/9363847
* Macfarlane, G. J., & Kronisch, C. (2021). Pharmacological and non-pharmacological treatment of fibromyalgia: an overview of the current evidence. *Expert Rev Neurother*, *21*(11), 1279-1286. doi:10.1080/14737175.2021.1994273
* Sluka, K. A., & Clauw, D. J. (2016). Management of Fibromyalgia Syndrome: A Comprehensive Review. *J Pain*, *17*(9 Suppl), T11-T24. doi:10.1016/j.jpain.2016.03.003
* Siracusa, R., D'Amico, R., Cuzzocrea, S., & Di Paola, R. (2021). Fibromyalgia: an update on diagnosis and treatment. *Clin Exp Rheumatol*, *39 Suppl 129*(6), 11-20. PMID: 34859750
Q.
Managing Fibromyalgia After 65: New Treatment Strategies
A.
New, lower-risk strategies for fibromyalgia after 65 emphasize individualized care, starting low and going slow with select antidepressants or anti-seizure medicines while avoiding long-term opioids, and prioritizing non-drug options such as gentle activity, physical therapy, sleep optimization, and CBT or mindfulness to reduce pain and protect function. There are several factors to consider; see below for medication safety tips and interaction checks, pacing plans and flare management, nutrition guidance, red-flag symptoms that need urgent care, and how to partner with your doctor on the right next steps.
References:
* Theoharides TC, Stewart JM. Fibromyalgia in older adults: treatment challenges and strategies. Curr Rheumatol Rep. 2019 Jan 22;21(1):1. doi: 10.1007/s11926-019-0797-0. PMID: 30671607.
* Hooten WM, et al. Pharmacological and non-pharmacological treatments for fibromyalgia in the elderly. Curr Pain Headache Rep. 2021 Jun;25(6):44. doi: 10.1007/s11916-021-00958-z. Epub 2021 May 3. PMID: 33947470.
* Bavalia R, et al. Fibromyalgia in the Elderly Patient. Curr Pain Headache Rep. 2019 Jul 24;23(9):68. doi: 10.1007/s11916-019-0808-7. PMID: 31102941.
* Mease P, et al. Management of Fibromyalgia in Older Adults: An Evidence-Based Approach. Drugs Aging. 2017 Aug;34(8):577-589. doi: 10.1007/s40266-017-0477-7. PMID: 28555319.
* Park J, et al. Treating Fibromyalgia in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Clin Med. 2022 May 9;11(9):2628. doi: 10.3390/jcm11092628. PMID: 35566735.
Q.
That Annoying "Flutter" Under Your Ribs: Is It Stress, or a Warning About Your Magnesium?
A.
That rib-area flutter is usually a benign muscle twitch called a fasciculation, most often triggered by stress, poor sleep, muscle fatigue, or low magnesium, and it often improves with magnesium-rich foods or guided supplements, hydration, gentle stretching, posture, and breathing work. There are several factors to consider; see below for red flag symptoms that warrant urgent care, how to decide on testing, other conditions and medications that can contribute, and practical next steps to discuss with your doctor.
References:
* Kass, L., Rosanoff, A., Tanner, M. A., & Seemann, R. (2022). Magnesium and health outcomes: An umbrella review of observational studies and meta-analyses. *BMC Medicine*, *20*(1), 1-17. pubmed.ncbi.nlm.nih.gov/35168593/
* Abbasi, B., & Chepurkov, A. (2022). Role of Magnesium in Neuromuscular Excitability and Spasms. *Journal of Clinical Medicine*, *11*(23), 7013. pubmed.ncbi.nlm.nih.gov/36555776/
* Hobson, B. B., & Hobson, D. A. (2018). Benign fasciculation syndrome: a review of the literature. *Muscle & Nerve*, *57*(3), 397-405. pubmed.ncbi.nlm.nih.gov/29322521/
* Sharma, S., & Tripathi, N. (2020). Psychological stress and muscle cramps: A review. *Journal of Clinical Orthopaedics and Trauma*, *11*(5), 940-943. pubmed.ncbi.nlm.nih.gov/32952402/
* Khurana, P., & Singh, A. (2019). Diaphragmatic flutter: A review of etiology, diagnosis, and treatment. *Respiratory Medicine Case Reports*, *26*, 100813. pubmed.ncbi.nlm.nih.gov/31333909/
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Ubie’s symptom checker demonstrated a Top-10 hit accuracy of 71.6%, surpassing the performance of several leading symptom checkers in the market, which averaged around 60% accuracy in similar assessments.
Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Clauw DJ. Fibromyalgia: a clinical review. JAMA. 2014 Apr 16;311(15):1547-55. doi: 10.1001/jama.2014.3266. PMID: 24737367.
https://jamanetwork.com/journals/jama/article-abstract/1860480Bair MJ, Krebs EE. Fibromyalgia. Ann Intern Med. 2020 Mar 3;172(5):ITC33-ITC48. doi: 10.7326/AITC202003030. PMID: 32120395.
https://www.acpjournals.org/doi/10.7326/AITC202003030Sarzi-Puttini P, Giorgi V, Marotto D, Atzeni F. Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment. Nat Rev Rheumatol. 2020 Nov;16(11):645-660. doi: 10.1038/s41584-020-00506-w. Epub 2020 Oct 6. PMID: 33024295.
https://www.nature.com/articles/s41584-020-00506-wSumpton JE, Moulin DE. Fibromyalgia. Handb Clin Neurol. 2014;119:513-27. doi: 10.1016/B978-0-7020-4086-3.00033-3. PMID: 24365316.
https://www.sciencedirect.com/science/article/abs/pii/B9780702040863000333?via%3Dihub