Fibromyalgia Flashcards
Painful, non-articular rheumatic condition present for at least 3 months in duration consisting of chronic muscular ache
aka Chronic Widespread Pain
Fibromyalgia
Name at least 4 clinical manifestations of fibromyalgia.
- Chronic, diffuse musculoskeletal ache, pain stiffness
- Multiple tender points (11 of 18 specific sites )
- Sleep disturbances (All 4 stages of sleep)
- AM stiffness, feeling of swollen extremities
- Muscular twitching
- Restless Leg Syndrome
- Chest pain
- Irritable bowel and bladder
- Anxiety, depression
- Paradoxical breathing pattern
- Fatigue
- Chronic headaches
- GI and urinary tract irritation
- Paresthesia (numbness, tingling)
- Sensitivity to light, noise
- Dry eyes, mouth
- Difficulty concentrating, memory impairment
Name 2 triggers of fibromyalgia.
- Overexertion
- Lack of exercise/too much exercise
- Stress, anxiety, depression
- Lack of/poor quality of sleep
- Trauma
- Environmental Stressors: Extremes in temp. or humidity; fluorescent lighting
Which of the following are NOT included in the assessment of fibromyalgia?
a) 11 of 18 tender point sites assessed by MD
b) Symptom severity scale
c) Only PROM
d) Breathing Pattern
c)
Which of the following is NOT a clinical manifestation of fibromyalgia?
a) Pain in muscles
b) ↓ ROM
c) Weakness
d) Ratchety
d)
Ratchety is a clinical manifestation of Myofascial Pain Syndrome
True or False?
In Fibromyalgia, there are trigger points, referral pain pattern and taut bands.
False. These are clinical manifestations of Myofascial Pain Syndrome.
What are the aims and treatment Goals for Fibromyalgia?
- Improve relaxation
- Improve circulation
- Decrease pain
- Improve quality of sleep
- Address postural imbalances
What are some techniques included in a patient’s treatment with fibromyalgia?
FB Relaxation – including abdomen Static Contact
Stroking, effleurage, kneading-slow, light, rhythmical
Lymphatic drainage
Hold/relax stretching
Fascial techniques – non-painful &/or indirect
Rhythmic mobilizations/joint mobilizations
Positional release therapy (PRT)
TP therapy – traps, SCM, Masseter, Temporalis, lateral pterygoids
1st tx – light to moderate pressure – see how cl responds
Shorten tx time if necessary
All of the following can be used as hydrotherapy for fibromyalgia, except:
a) Thermophore
b) Cold compress
c) Full Body Steams
d) Heating compress
b)
- Gradually ↑ ADL
- Initially – mild exercise for 6-8 weeks, aerobic – pool exercises, swim, walk, Tai Chi, gentle/Restorative yoga
- Strengthen mm via endurance program
- May be discouraged d/t pain, be supportive and encouraging
- Avoid fatigue
Remedial Exercise for Fibromyalgia
Sleep Hygiene
- term used to describe good sleeping habits.
- a set of guidelines and tips which are designed to enhance good sleeping.
- evidence suggests that these strategies can provide long-term solutions.
- used in conjunction with cognitive therapy, medications or alone.
Other Recommendations for Fibromyalgia
- Analgesics: Acetaminophen: Tylenol, Liquiprin, Datril (Pain)
- Antidepressants: Amitriptyline, Elavil, Zyban, Cymbalta cyclobenzaprine, Xanax (All to improve sleep)
- Corticosteroids: prednisone, cortisone (For severe pain)
- Muscle Relaxants: Flexeril, Robaxin
- Anti-seizure: Pregabalin (Lyrica)
- THC nasal spray or medical marijuana
- SSRI’s: Celexa, Prozac, Zoloft (Pain and depression)
Fibromyalgia Medical Treatment
- Deep work if not tolerated
- Meds: muscle relaxants, analgesics, anti-depressants – modify accordingly
Fibromyalgia Contraindications
