Fibromyalgia

Question 1

Define fibromyalgia

Answer 1

chronic pain disorder.

more than 3 months.

Question 2

Risk factors for fibromyalgia.

Answer 2

• Women >men, 20-60 (peak 40-50)
• PMHx – rheumatic disease, osteoarthritis, inflammatory arthritis.
• FHx of fibromyalgia

Question 3

Describe the classic presentation of fibromyalgia.

Answer 3

Chronic widespread body pain for 3 months.

Pain associated with fatigue, sleep, memory and mood difficulties.

• “Pain all over” – commonly:
  o Low back pain with or without radiation to buttocks and legs.
  o Pain in neck and shoulders
• Fatigue
• Sleep disturbance – can exacerbate condition and worsen depression.
• Morning stiffness
• Cognitive problems – memory and difficulty with words.
• Light headed/ dizzy
• Anxiety and depression
• Hyperalgesia with multiple trigger points.
• Associated symp - Headaches (can be migraines), abd pain, urinary freq, paresthesia of hands and feet.

symp worse in cold, humid weather and when stressed.

Question 4

How is fibromyalgia diagnosed?

Answer 4

diagnosis of exclusion.

• Bloods – TFT, ESR/ CRP – to rule out DDX (e.g rheumatoid arthritis, SLE).
  o All bloods and imaging normal in fibromyalgia.

diffuse tenderness on exam.
11/18 tender trigger points.

Question 5

Management of fibromyalgia

Answer 5

• No cure, Tx aims to relieve symp.
• Medicines – 1st line amitriptyline
• CBT and counselling
• Lifestyle – exercise and relaxation techniques.