| Initial approach in every patient |
| Confirm the diagnosis |
| Education |
- Regarding the condition, prognosis
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| |
| |
| Evaluate and treat comorbidities, such as mood and sleep disturbances |
| Most patients |
| Trial with low-dose tricyclic antidepressants or selected antidepressants or anticonvulsants proven effective in fibromyalgia |
| Exercise program |
| Patients not responding to above |
| Specialty referral (eg, rheumatologist, physiatrist, psychiatrist, pain management) |
| Combinations of drug therapies |
| Physical therapy measures |
| Psychological interventions, such as cognitive behavioral therapy |
| Multidisciplinary programs |
