01588nam a2200301   4500001000800000005001700008007000300025008004100028040000800069041000800077100003800085245001700123300002300140520069100163650003500854650003000889650004200919650003600961650002900997650001701026650001001043650002201053650002401075700002901099773011001128942003101238999001701269ESSALUD20260804163623.0ta      t        pe ||||| |||| 00| 0 spa d  aBMG  aeng  aWilliams, David A. eAutor953761  aFibromyalgia  apáginas: 267-277  aFibromyalgia is characterized by widespread pain involving any body tissue and typically accompanied by fatigue and problems with sleep, mood, and memory. Fibromyalgia can occur alone or in combination with other chronic overlapping primary pain conditions, or it can be superimposed on other conditions, such as autoimmune disorders (secondary pain). In fibromyalgia, the central nervous system (CNS) is hyperresponsive to sensory stimuli generally. Successful pharmacologic and nonpharmacologic interventions focus on the CNS to support CNS quiescence and a return to homeostasis. Although fibromyalgia is rarely curable, most cases can be well managed in the context of primary care.  aMEDICINA DEL ADOLESCENTE95533  aMEDICINA CLÍNICA933681  aMEDICINA CLÍNICA AMBULATORIA953762  aENFERMEDAD NEUROMUSCULAR953763  aENDOCRINOLOGÍA 936891  aNEUROLOGÍA  aDOLOR  aPEDIATRÍA96401  aPSIQUIATRÍA95413  aClauw, Daniel J. 9537640 022717922636dMassachusetts NEJM GroupoNEJM003tThe New England Journal of Medicine wESSALUDx0028-4793  cARTICULOSe2026-07-31zSQB  c22740d22740