Fibromyalgia Flashcards
What is fibromyalgia?
A common disorder of central pain processing characterized by chronic widespread pain in all 4 quadrants of the body
Includes both sides and above and below the waist. Often accompanied by allodynia.
What is allodynia?
A heightened and painful response to innocuous stimuli
Commonly present in fibromyalgia patients.
What is a significant trigger for fibromyalgia?
Deliberate sleep deprivation
Sleep disturbance is probably the trigger in most patients.
What findings do EEG studies show in fibromyalgia patients?
Reduced REM sleep and delta wave sleep
These alterations contribute to hyper-activation in response to noxious stimulation and activation in brain regions associated with pain perception in response to non-painful stimuli
List some common symptoms of fibromyalgia.
- Joint/muscle stiffness
- Profound fatigue
- Unrefreshed sleep
- Numbness
- Headaches
- Irritable bowel/bladder syndrome
- Depression and anxiety
- Poor concentration and memory (‘fibrofog’)
Symptoms are not restricted to pain.
What physical examination findings are expected in fibromyalgia?
No physical abnormalities in musculoskeletal or neurological systems
Patients may have ‘tender points’ on palpation.
What are ‘tender points’?
Areas where patients experience excess discomfort when palpated with sufficient pressure
Tender points are used in the assessment of fibromyalgia.
What is the male to female ratio for fibromyalgia prevalence?
9:1
Affects approximately 5% of the population.
What are some common triggers for the onset of fibromyalgia?
- Emotional triggers
- Physical triggers (e.g., painful arthritis)
Onset may have an obvious trigger.
What is a recommended approach to treating fibromyalgia?
Tailor treatment based on pain intensity, function, and associated features
Features include depression, fatigue, and sleep disturbance.
What medication is primarily used for fibromyalgia treatment?
Low dose amitriptyline
Pregabalin may also be effective; opiates are not recommended.
What therapeutic approach is effective for fibromyalgia?
Cognitive behavioural therapy (CBT)
CBT is effective in managing symptoms.
Fill in the blank: Not all patients with fibromyalgia have _______.
[tender points]
Important to note that many diseases can resemble fibromyalgia.
What blood tests are recommended to help exclude other pathologies in fibromyalgia diagnosis?
- ESR
- CRP
- FBC
- U+E
- LFT
- Ca
- CK
- TFT
These tests help in ruling out other conditions.
