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Fibromyalgia Features — SCE Rheumatology MCQ

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HardSoft Tissue RheumatologyFibromyalgia FeaturesSCE Rheumatology

A patient meets criteria for fibromyalgia/chronic primary pain after an appropriate search for inflammatory and neurological mimics. She requests pregabalin because a relative improved on it. Which plan best reflects NICE NG193?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Offer supervised exercise and discuss an antidepressant trial through shared decision-making

Explanation lettering: E = shown as A · A = shown as B · B = shown as C · C = shown as D · D = shown as E

D is correct. NICE recommends supervised exercise and permits a shared-decision trial of an antidepressant for chronic primary pain, even without depression. A initiates a gabapentinoid that NICE advises against for this indication. B introduces an opioid with poor long-term benefit. C adds NSAID and paracetamol despite no inflammatory target. E misrepresents acceptance-based or cognitive therapy, which can be offered without denying the reality of pain.

Reference: NICE NG193: chronic pain recommendations: https://www.nice.org.uk/guidance/ng193/chapter/Recommendations