4.4 Fibromyalgia Flashcards
1
Q
Define FM
A
First Criteria
Hx Chronic
Spontaenous
Widespread pain
>3/12
Including 3 features:
- Pain
Diffuse
deep throbbing
Variable intensity - Fatigue
Worst mornings
peaking again early afternoon - Sleep disturbance
Difficulty initiating and maintaining sleep
Frequent wakiening
2
Q
FM may also include
A
- Morning stiffness
Post exercise pain
Skin tenderness - Tension
Migraine like headaches
Dizzyness - Paraesthesia
- Restless legs
Mood disturbances - Fluid restriction
3
Q
Second Criteria
A
American Coll Rheum
Bilateral pain distribution
Pain above and below waist
Axial skeletal pain
Tenderness on digital palpation of 11/18 points
4
Q
Rx options
A
Aims decrease sy and improve QOL
- General Measures
- Specific therapies
5
Q
- General Measures
A
- Patient education
awareness condition and chronicity - Encourage positive outlook
remain active - Ownership
- Support groups
6
Q
- Specific Therapy
Pharm
A
- PO pharmacologic
- Standard analgesia
paracetamol
NSAID
Tramadol (Min evidence benefit) - Neurotransmitter modifiers
Duloxetine / Fluoxetine - TCA
Amitriptyline - Antiepileptic
Gabapentin / pregabalin
7
Q
- Specific Therapy
Pharm
A
- NMB agent
Clycobenazapine - SSRI
8/ MAOi
Pirindole
- Hypnotics
zs - Zds
8
Q
Specific Therapy
Other
A
- Trigger point injections
Mix of LA +- steroid
Benefit short and med term
- IV therapy
Lidcaoine as bolus 3-5ml/kg
infusion block disordered pain path
9
Q
Non Pharm
A
Exercise
Warm baths
Psych assessment Rx CBT Health Anxiety Relaxation Mindfulness
10
Q
Complementary Tx
A
Acupuncture
TENS
Hydrotherapy
