008. Fibromylagia and Chronic fatigue

Question 1

What is fibromyalgia?

Answer 1

Relapsing and remitting syndrome of chronic pain and profound fatigue

Hypothesised to be a dysfunction in the peripheral and central pain processing centres

Question 2

What are the risk factors for fibromyalgia?

Answer 2

Female

Middle age

Low household income

Divorced

Low educational status

Question 3

What are the associated conditions for fibromyalgia?

Answer 3

Chronic fatigue syndome

IBS

Chronic headache syndromes

Question 4

What are the features of fibromyalgia?

Answer 4

Chronic pain

profound fatigue

difficulty sleeping

poor concentreation, low mood

Question 5

How do you investigate fibromyalgia?

Answer 5

Look to exclude major differentials: PMR, Vasulitis, hypothyroidism, myeloma)

Fibromyalgia will have normal investigation results

Question 6

What is the treatment for fibromyalgia?

Answer 6

Reeview new symptoms to exclude alternative diagnosis

Graded exercise programmes and phsyio involvement

Relaxation rehabilitation adn phsyiotherapy

CBT

Question 7

What medications are given to aid the treatment of fibromyalgia?

Answer 7

Amitriptylinne

pregabalin

Duloxetine if comorbid anxiety or depression

Question 8

Chronic fatigue syndrome is completely different to fibromyalgia.

Discuss the main symptoms

Answer 8

Persisitant diabling fatigue lasting >6 months

Affects physical and mental function as well as:

myalia, polyarhtralgia, memory loss, poor sleep, fatigue after exertion

Question 9

How is chronic fatigue syndrome treated?

Answer 9

Exercise programmes

CBT

No proven pharmacological management