Fibromyalgia

Question 1

Demographics:

Answer 1

Young to middle aged women,women 7:1 men

Question 2

Aetiology:

Answer 2

Unknown

Question 3

What can aggravate fibromyalgia?

Answer 3

• Environmental or emotional stress- poor sleep- trauma- exposure to dampness or cold - physician who implies that the disorder is “all in the head.”

Question 4

Does fibromyalgia cause tissue damage?

Answer 4

No, Allodynia is felt in the areas of pain.

Question 5

Signs and symptoms of FM?

Answer 5

Patient has generalised, chronic, wide spread deep pain Tender points in back of neck, shoulders lower back, hips knees and shinsProblems with concentration and memoryIrritable bowel (diarrhoea, stomach pain)Anxiety and/or depression, extreme fatigue

Question 6

When is the pain worst for patients with fibromyalgia?

Answer 6

After rest (eg. first thing in the morning) or after activity

Question 7

What objective tests can be done to diagnose fibromyalgia?

Answer 7

None. Only subjective means such as patient self-report forms and clinical psychometric testing.

Question 8

What is the prognosis for fibromyalgia?

Answer 8

There is no cure, best to manage and improve lifestyle and provide support.

Question 9

Implicated Aetiology:

Answer 9

• Abnormal neuroendocrine function
• Excessive ACTH
• Low insulin
• Decreased BOLD in thalamus, basal ganglia and mid brain

Question 10

What is the criteria for FM

Answer 10

At least 3 months of wide-spread pain Pain and tenderness in 11/18 of the tender points.

Question 11

What is the the role of aerobic exercise in rehabilitation of FM?

Answer 11

• Low intensity aerobic exercise and pool exercise can improve function and symptoms

Question 12

Exercise recommendations for FM:

Answer 12

Aerobic exercise 2x a week at moderate intensity• High-intensity exercise should be undertaken with caution• Exercise prescriptions should be individualised and should include along-term plan to maximise functioning and wellbeing• Small increments• Low RPE rating may be necessary at first

Question 13

Acute and Chronic Responses to Exercise:

Answer 13

• Post-exertional pain • Adherence

Question 14

Beneficial Adaptations to Exercise:

Answer 14

• Improved function and well-being• Reverses physical inactivity spiral• Important reduced risk of co-morbidities

Question 15

Contraindications and Adverse effects of exercise in FM

Answer 15

• Perceptual and cognitive