Fibromyalgia

Question 1

What is fibromyalgia?

Answer 1

Fibromyalgia is a chronic pain disorder. The cause of fibromyalgia is unknown, but there is some evidence for a genetic predisposition, abnormalities in the stress response system or hypothalamic-pituitary axis, and possible triggering events

Question 2

What is the gender bias in fibromyalgia?

Answer 2

Women are 10 times more commonly affected than men

Question 3

What conditions often present alongside fibromyalgia?

Answer 3

Fibromyalgia is not a diagnosis of exclusion and often occurs in patients with other conditions, such as inflammatory arthritis and osteoarthritis

Question 4

What are the signs and symptoms of fibromyalgia?

Answer 4

Pain at various places in the body. Low back pain with/without radiation to the buttocks and legs and pain in the neck and across the shoulders are common complaints

Fatigue

Sleep disturbance

Morning stiffness

Symptoms are generally reported as worse in cold, humid weather and under times of stress

Question 5

How would you diagnose fibromyalgia?

Answer 5

A patient fulfils the diagnostic criteria for fibromyalgia if the following three conditions are met:

1. Widespread pain index (WPI) is 7 and symptom severity (SS) scale score is 5, or WPI equals 3 to 6 and SS scale score of 9.
2. Symptomatology has been present at a similar level for at least three months.
3. The patient does not demonstrate any other disorder that would otherwise explain the pain.

Question 6

How would you manage fibromyalgia?

Answer 6

The aim of treatment is not to cure fibromyalgia but to reduce symptoms and improve quality of life

Pain and function should be assessed in a psychosocial context.

Exercise and CBT instead of longterm medication