FIBROMYALGIA

Question 1

central pain syndrome with widespread pain and fatigue, not nociceptive pain, neuropathic pain

part of a larger spectrum of central sensitivity disorders

Answer 1

fibromyalgia

Question 2

fibromyalgia can overlap with what other syndromes?

Answer 2

chronic fatigue syndrome

psychiatric disorders

somatoform disorders

regional pain syndromes

Question 3

genetic traits

Answer 3

first degree relatives have an 8 fold greater risk

family members have regional pain syndromes

polymorphisms can occur affecting metabolism

Question 4

environmental factors

Answer 4

trauma

• early life
• physical trauma
• peripheal pain

psychological stress

certain infections (hep C, EBV, parvovirus, Lyme disease)

certain catastrophic events

Question 5

describe the aberrant sensory and pain?

Answer 5

volume control

lowered pain threshold through entire body

global problem with sensory processing: loudness sensitivity

Question 6

diagnosis hx?

Answer 6

pain
fatigue
insomnia
memory difficulties

Question 7

eval test?

Answer 7

inflammatory markers
CBC
TSH, vit D
not autoantibodies 
ANA-does not indicate lupus
secondary fibromyalgia associated with: RA, CTD, HLAB27, AS

Question 8

tx principles?

Answer 8

education
aerobic exercise
CBT
meds
aerobics, yoga

Question 9

main meds used?

Answer 9

NSRI

• TCAs
• cyclobenzaprine
• venlafaxine

Anticonvulsants

• pregabalin
• gabapentin

other
-tramadol, SSRIs, sedatives

avoid: NSAIDs, corticosteroids, opioids

Question 10

what is key?

for diagnosis*

Answer 10

education

*manage symptoms of pain, emphasize low grade exercise, use CBT, other resources like the arthritis foundation