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  • Fibromyalgia syndrome (FMS) is a chronic noninflammatory, nonautoimmune central afferent processing disorder leading to a diffuse pain syndrome as well as other symptoms. 

  • Similar to patients with other chronic pain disorders, functional magnetic resonance images (MRIs) show expanded receptive fields for central pain perception and emotional modulation in patients with fibromyalgia. 

  • The most effective drugs for FMS are tricyclic agents (TCAs), dual reuptake inhibitors, and anticonvulsants, which downregulate sensory processing. 

  • Opioids and corticosteroids are not effective in the treatment of fibromyalgia and should be avoided. 

  • Patient education, aerobic exercise, and cognitive behavioral therapy are important adjuncts to medical therapy of FMS.