Fibromyalgia

Question 1

what is fibromyalgia

Answer 1

unexplained condition causing widespread muscle pain and fatigue

Question 2

who is it common in

Answer 2

young and middle aged women

Question 3

what is fibromyalgia thought to be a disorder of

Answer 3

central pain processing or central sensitivity

Question 4

do patients have the same sensitivity to other stimuli e.g heat, noise and strong smells

Answer 4

no

decreased

Question 5

although not fully understood what is the pathogenesis

Answer 5

biochemical, metabolic and immunoregulatory abnormalities

Question 6

although usually seen as a primary condition condition what other conditions can this occur with

Answer 6

RA (25%)

lupus (50%)

Question 7

what is the presentation

Answer 7

• persistent (>3 months) widespread pain (both sides, above and below waist including axial spine)
• fatigue
• cognitive difficulties
• unexplained symptoms e.g depression or anxiety, IBS and migraines

Question 8

what are the investigations

Answer 8

none diagnosis is clinical

Question 9

what conditions are important to rule out

Answer 9

hypothyroidism, RA, lupus, polymyalgia rheumatica, inflammatory or autoimmune conditions

Question 10

what is the management

Answer 10

self management, validation, graded exercise, atypical analgesia (e.g amitriptyline), psychological input