Fibromyalgia

Question 1

What time length defines chronic pain?

Answer 1

Pain > 3 months

Question 2

What is the most common cause of chronic widespread msk pain?

Answer 2

Fibromyalgia

Question 3

Fibromyalgia is more common in what sex?

Answer 3

Females

Question 4

Describe the etiology, labs and patient appearance with Fibromyalgia?

Answer 4

NO trigger of etiology

– NORMAL labs and appearance of patient

Question 5

In order to diagnose Fibromyalgia, what 3 conditions must be met?

Answer 5

1. Widespread pain index > 7
2. Symptom severity scale > 5
3. Symptoms present > 3 months
   - - no other cause of pain

Question 6

In order to diagnose Fibromyalgia, what 3 conditions must be met?

Answer 6

1. Widespread pain index > 7
2. Symptom severity scale > 5
3. Symptoms present for > 3 months
   - - no other cause of pain

Question 7

Besides the normal Fibromyalgia diagnostic criteria, what is another way to meet the diagnosis?

Answer 7

Widespread pain index: 3-6 and Symptom severity scale > 9

Question 8

What are the main symptoms of Fibromyalgia?

Answer 8

• Chronic widespread msk pain

- Fatigue/sleep disturbances

Question 9

What are the main symptoms of Fibromyalgia?

Answer 9

• Chronic widespread msk pain

- Fatigue/sleep disturbances

Question 10

What are some associated symptoms with Fibromyalgia? (3)

Answer 10

Mood disorders
Headaches
GI issues

Question 11

What is a common mood disorder with fibromyalgia?

Answer 11

Depression

Question 12

What may be reflective of the CNS dysfunction with Fibromyalgia?

Answer 12

Sleep disturbances

Question 13

Those with Fibromyalgia may have ____

Answer 13

Altered pain processing

– lower threshold

Question 14

What is the main exam finding with Fibromyalgia?

Answer 14

Soft tissue tenderness with palpation

Question 15

What is the main exam finding with Fibromyalgia?

Answer 15

Soft tissue tenderness with palpation

Question 16

Is there inflammation present with Fibromyalgia?

Answer 16

NO

– exclude with cbc, esr, crp

Question 17

What is the first thing to do with your Fibromyalgia patients?

Answer 17

EDUCATE

• • reassure that their symptoms are not imaginary
• • symptoms will not spiral downward
• • can live a normal life

Question 18

Managing ____ may help manage Fibromyalgia symptoms

Answer 18

Managing mood

Question 19

What is the first treatment to consider with Fibromyalgia?

Answer 19

Exercise

Question 20

What should you tell your patient with Fibromyalgia about exercise?

Answer 20

It will be painful at first

- use stepwise approach and gradually increase

Question 21

What are examples of exercise that are helpful with Fibromyalgia?

Answer 21

Tai chi
Yoga
– All exercise really

Question 22

What drugs are strongly NOT used with Fibromyalgia?

Answer 22

Growth hormone

Sodium Oxybate

Question 23

What drugs are weakly NOT used with Fibromyalgia?

Answer 23

NSAIDs
MAOIs
SSRIs

Question 24

After Exercise is added for Fibromyalgia patients, what should be considered next for treatment?

Answer 24

Meditative movement therapies like acupuncture

Question 25

Correcting what vitamin deficiency may help treat Fibromyalgia?

Answer 25

Vitamin D

Question 26

Correcting what vitamin deficiency may help treat Fibromyalgia?

Answer 26

Vitamin D

Question 27

What OMT should you start with for Fibromyalgia?

Answer 27

Indirect MFR

Question 28

What OMT should you start with for Fibromyalgia?

Answer 28

Indirect MFR

Question 29

What may help with sleep for Fibromyalgia?

Answer 29

Cannabinoids

Question 30

Pharm options are used for what with Fibromyalgia?

Answer 30

Mood disorders

Severe pain and sleep disturbances