When to refer a patient with fibromyalgia to a specialist

Fibromyalgia is common; general practitioners need to be equipped with strategies for assessment and management. Rheumatological assessment can help confirm the diagnosis, exclude alternative diagnoses, and assist the patient to understand and deal with their condition; however, it is not necessary for every patient. Referral should be considered if the patient has an atypical presentation or refractory symptoms. When abnormal mood or adjustment disorders are a feature, psychological or psychiatric assessment may be advisable.