Fibromyalgia

Question 1

What is fibromyalgia?

Answer 1

Fibromyalgia is a syndrome characterised by widespread pain throughout the body with tender points at specific anatomical sites. The cause of fibromyalgia is unknown.

Question 2

Epidemiology of fibromyalgia?

Answer 2

women are around 5 times more likely to be affected
typically presents between 30-50 years old

Question 3

Features of fibromyalgia?

Answer 3

chronic pain: at multiple site, sometimes ‘pain all over’
lethargy
cognitive impairment: ‘fibro fog’
sleep disturbance, headaches, dizziness are common

Question 4

Diagnosis of fibromyalgia?

Answer 4

Diagnosis is clinical and sometimes refers to the American College of Rheumatology
classification criteria which lists 9 pairs of tender points on the body. If a patient is tender in at least 11 of these 18 points it makes a diagnosis of fibromyalgia more likely

Question 5

Management of fibromyalgia?

Answer 5

explanation
aerobic exercise: has the strongest evidence base
cognitive behavioural therapy
medication: pregabalin, duloxetine, amitriptyline