FIBROMYALGIA Flashcards
What is fibromyalgia?
-a condition of chronic widespread pain accompanied by the finding of soft-tissue tenderness on examination, located over a number of trigger points.
Describe the pathophysiology of fibromyalgia
- The exact cause is unknown
- Predominantly affects women between the ages of 30 and 60 years
What are the risk factors for fibromyalgia?
- Female
- Middle age
- Low household income
- Divorced
- Low education status
What are the signs of fibromyalgia?
-Presence of soft-tissue tenderness, usually at multiple sites
What are the symptoms of fibromyalgia?
- Long history of widespread pain which responds poorly to analgesia
- Fatigue
- Sleep disturbance
- Poor concentration
- Headache
- Paraesthesia
- Anxiety
- Depression
- Altered bowel habit.
How is fibromyalgia diagnosed?
It’s a clinical diagnosis, any investigations are used to exclude other diagnoses
What is the goal of treatment for fibromyalgia?
- There is no specific treatment.
- Addressing social stressors and depression is essential if better outcomes are to be obtained.
What is the non-pharmacological treatment for fibromyalgia?
Education:
- Inform patients about the condition - It is helpful to explain that the pain is real and not simply ‘in their head’.
- Reassure them that they do not have a destructive arthritis.
- Emphasize that they will not harm their joints by exercising.
Physiotherapy/exercise:
-A graded aerobic exercise regime can improve fitness and reduce pain and fatigue
Cognitive behavioural therapy to develop coping strategies and set achievable goals
What is the pharmacological treatment for fibromyalgia?
Some drugs can help slightly:
- Tricyclic antidepressants e.g. amitriptyline, can help relieve pain and improve sleep
- Anticonvulsants (pregabalin, gabapentin) - can be used if amitriptyline is ineffective
-Dual reuptake inhibitors (duloxetine) - Useful for anxiety and depression
