Fibromyalgia

Question 1

What is Fibromyalgia and what is an easy way to treat?

Answer 1

Not a disease, is a condition of life
Aerobic and strengthening exercises are the number 1 way to improve symptoms
Get them up and moving
A lot of military members that were in desert storm are developing Fibromyalgia related to the chemicals that were used in warfare

Question 2

How many people does Fibromyalgia effect and who does it mainly effect?

Answer 2

Disorder of pain processing- chronic syndrome
Hard to diagnose
It effects 10 million Americans-75%-90% are made up of women
Diagnosis occurs between ages 20-50

Question 3

What is the pathophysiology of Fibromyalgia?

Answer 3

Chronic syndrome of unknown cause such as Infection, Trauma, stressors may trigger
Pain is at specific tender points such as lower neck, upper breast, spine, shoulders
Neurogenic- nervous system is malfunctioning=pain receptors are reacting when there is no stimulus
Sometimes infection can be related to Hep C

Question 4

What are Risk factors of Fibromyalgia?

Answer 4

Female, 20-50 years of age
Sometimes runs in families
Psychiatric disorders (ADHD or depression)
Medical Disorder-Irritable bowel syndrome, Rheumatoid arthritis
Genetics

Question 5

How do you prevent Fibromyalgia?

Answer 5

No way to prevent 
No cure
Maintain healthy lifestyle
Strenuous exercise
Prompt diagnosis and treatment symptoms can reduce flare ups and manage pain and fatigue

Question 6

What are manifestations of Fibromyalgia?

Answer 6

Pain and stiffness are worst in the morning
Usually gets better after moving
Pain worsens after activity
Widespread pain
Sleep disturbances
Enhanced sensitivity to heat and cold

Question 7

When is Fibromyalgia most to occur during the lifespan?

Answer 7

Most common in middle aged women
Girls right at puberty might develop it then it could go away
Triggers in children are generally the same
30-40% of children no longer report widespread pain after 3-4 years
20% report no pain by 20 years old

Question 8

What is important to remember when collaborating with the patients family?

Answer 8

Families can make codependent. Patient is not an invalid. Patient needs to get up and move and take care of themself as much as possible

Question 9

What diagnostic tests are used?

Answer 9

You use diagnostic tests to rule out other conditions
Patient can have pain in four quadrants of the body
Painful response on 11 of the 18 tender points

Question 10

What is the use of Pregabalin? (Lyrica)

Answer 10

Increases neuronal GABA levels
Contraindications/Cautions: suicidal ideation, depression, renal impairment, history of drugs or Alcohol abuse, CHF
Adverse Effects: Ataxia, amnesia, dizziness, neuropathy, abnormal thinking, vertigo, chest pain, diplopia, edema, weight gain
Avoid alcohol and don’t stop abruptly

Question 11

What is used in the nonpharmacologic therapy of Fibromyalgia?

Answer 11

relaxation therapy
Strength training
Cognitive-behavioral therapy

Question 12

What are the goals for the Fibromyalgia patient?

Answer 12

Reduce pain
Increase restorative sleep
Often diagnosed only after other diagnoses are ruled out

Question 13

What do you assess in the Fibromyalgia patient?

Answer 13

Based on history
widespread pain for at least 3 months
Pain at 11 of 18 tender points
Absence of disorder that would explain pain

Question 14

What is important to plan for the fibromyalgia patient’s care?

Answer 14

Decrease Pain
Able to sleep-fewer disturbances
Get them up and moving

Question 15

What is important to implement for optimal outcomes?

Answer 15

8 hrs of sleep- have a ritual, no caffeine past a certain time