Fibromyalgia Flashcards
Fibromyalgia symptoms
Most common:
-Chronic widespread pain
-Fatigue and sleep alterations
Others:
-autonomic disturbances
-cognitive dysfunction
-hypersensitivity
-somatic symptoms
-psychiatric disorders
Fibromyalgia prevalence
Ages 20-55 (peak 50-60 yrs)
Women 90%
Diagnosis tools of fibromyalgia
Subjective reports
Clinical assessments
ACR Diagnositc Criteria for Fibromyalgia
1.
Widespread Pain Index: 7+
Symptom Severity Score: 5+
or WPI 3-6 AND SSS 9+
- Symptoms present for at least 3 months
- Patient does not have a disorder that would otherwise explain the pain
Hypothesized Etiology of Fibromyalgia
At level of PNS/CNS, interaction b/w pathogenic mechanisms (causative factors) and nociplastic alterations in nervous system
Interplay of peripheral and central mechanisms -> nociplastic pain condition
Signs that support hypothesized etiology of fibromyalgia
Low threshold of pain tolerance
Hyperalgesia and allodynia
High measures of pain sensitization
High response in pain processing areas of brain
Treatment of fibromyalgia
Patient education and fitness (PT)
Pharmacology
Psychotherapy
With holistic, multimodal, inter-professional approach
Education on fibromyalgia
- Follow principles of PNE (pain neuroscience ed.)
-acknowledge condition is real/legit
-nociplastic nature of condition
-internal locus of control/collaborative goal setting - Wellness
-sleep hygiene
-stress reduction, relaxation techniques
-self efficacy
Exercise/fitness with fibromyalgia
Monitor HR/BP (typically BP low, HR high)
Low-mod aerobic exercise, flexibility, strength
Short sessions initially (3-5 min)
Use RPE scale to measure tolerance
30 min/d of exercise
Manual therapy and modalities with fibromyalgia
Weak evidence for manual therapy
No to weak support for modalities
Gentle with manual therapy due to risk of activating sensitized peripheral nociceptors
Outcomes for fibromyalgia
Pt personal goals
Global rating of change
Fatigue levels
Sleep patterns
QOL
Functional ability/tolerance
Elimination of meds
