**Recognize Comorbid Fibromyalgia Syndrome in Order to Better Evaluate Selected Rheumatic Diseases to Better Evaluate Selected Rheumatic Diseases**

**Recognize Comorbid Fibromyalgia Syndrome in Order** 

DOI: 10.5772/intechopen.73123

William S. Wilke William S. Wilke Additional information is available at the end of the chapter

[80] Lima PSS, Lucchese AM, Araújo-Filho HG, Menezes PP, Araújo AAS, Quintans-Júnior LJ, et al. Inclusion of terpenes in cyclodextrins: Preparation, characterization and phar-

[81] Quintans-Júnior LJ, Oliveira MGB, Santana MF, Santana MT, Guimarães AG, Siqueira JS, et al. α-Terpineol reduces nociceptive behavior in mice. Pharmaceutical Biology. 2011

[82] Awouafack MD, Tane P, Kuete V, Eloff JN. Sesquiterpenes from the medicinal plants of

[83] Katsuyama S, Mizoguchi H, Kuwahata H, Komatsu T, Nagaoka K, Nakamura H, et al. Involvement of peripheral cannabinoid and opioid receptors in β-caryophyllene-

[84] Klauke A-L, Racz I, Pradier B, Markert A, Zimmer AM, Gertsch J, et al. The cannabinoid CB2 receptor-selective phytocannabinoid beta-caryophyllene exerts analgesic effects in mouse models of inflammatory and neuropathic pain. European

[85] Gama KB, Quintans JSS, Antoniolli ÂR, Quintans-Júnior LJ, Santana WA, Branco A, et al. Evidence for the involvement of descending pain-inhibitory mechanisms in the antinociceptive effect of Hecogenin Acetate. Journal of Natural Products. 2013 Apr

[86] Rutledge DN, Jones CJ. Effects of topical essential oil on exercise volume after a 12-week exercise program for women with fibromyalgia: A pilot study. Journal of Alternative

[87] Ablin J, Fitzcharles M-A, Buskila D, Shir Y, Sommer C, Häuser W. Treatment of fibromyalgia syndrome: Recommendations of recent evidence-based interdisciplinary guidelines with special emphasis on complementary and alternative therapies. Evidence-Based

macological approaches. Carbohydrate Polymers. 2016;**151**:965-987

Africa. In: Medicinal Plant Research in Africa. Elsevier; 2013. pp. 33-103

induced antinociception. European Journal of Pain. 2013 May;**17**(5):664-675

Neuropsychopharmacology. 2014 Apr;**24**(4):608-620

and Complementary Medicine. 2007 Dec;**13**(10):1099-1106

Complementary and Alternative Medicine eCAM. 2013;**2013**:485272

Jun 8;**49**(6):583-586

78 Discussions of Unusual Topics in Fibromyalgia

26;**76**(4):559-563

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.73123

#### **Abstract**

The prevalence of comorbid fibromyalgia syndrome in autoimmune rheumatic diseases is clinically significantly higher than is fibromyalgia syndrome in the general population. By increasing pain sensitivity and fatigue, it disproportionately inflates subjective signs and symptoms, thereby obfuscating composite indices used to measure biological disease activity, the degree of disability, and the quality of life. By modifying primary disease phenotype, it also interferes with diagnostic precision. This review documents its effects on rheumatoid arthritis, the spondyloarthropathies, and systemic lupus erythematosus; and offers a general remedial strategy.

**Keywords:** fibromyalgia, disease activity, diagnosis, outcomes
