Fibromyalgia

Question 1

What are 4 characteristics of fibromyalgia?

Answer 1

1. Constant pain in multiple muscles, ligaments, tendons located on both sides of the body above and below the waist
2. Systemic fatigue
3. Inability to think clearly (‘brain fog’)
4. Sleep and/or mood issues

Question 2

What are tender points?

Answer 2

Specific anatomical locations where slight pressure causes pain

Question 3

How many tender points are there? Where are they? (9)

Answer 3

18 tender points total

1. back of the head
2. between the scapulae
3. top of the shoulders
4. front sides of the neck
5. upper chest
6. lateral elbow area
7. upper hips,
8. side of the hips
9. inner knees

Question 4

How many tender points must be symptomatic to indicate fibromyalgia?

Answer 4

Presence of pain with pressure on at least 11 of these 18 tender points using a pressure algometer is indicative of fibromyalgia

Question 5

What is the etiology of fibromyalgia? What percentage of the population is affected?

Answer 5

1. Etiology: Unknown

2. Affects 2% of US population

Question 6

Fibromyalgia is thought to ______ painful sensations by affecting the way the brain processes ________.

Answer 6

1. Amplify

2. Pain signals

Question 7

List 5 risk factors for fibromyalgia.

Answer 7

1. Female sex
2. Family history
3. Sleep disorders
4. Age
5. RA

Question 8

List 3 medications that can reduce pain and improve sleep in patients with fibromyalgia.

Answer 8

1. analgesics
2. antidepressants
3. anti-seizure medications (Gabapentin, Lyrica)

Question 9

What 2 techniques should the PT instruct fibromyalgia patients on?

Answer 9

1. Techniques to get adequate sleep

2. Techniques to reduce stress

Question 10

What 5 things should be assessed during the PT examination of a patient with fibromyalgia?

Answer 10

1. History
2. Functional status
3. Gait
4. Endurance
5. General description of strength and ROM

Question 11

List 4 interventions used in PT management of fibromyalgia.

Answer 11

1. Instruction in techniques to pace oneself with daily activities
2. Exercise
3. Soft tissue mobilization
4. Specific intervention for the patient’s impairments

Question 12

There is strong evidence supporting the implementation of an _____ exercise program to manage symptoms and improve physical function, and moderate evidence for performing _____ exercise to manage symptoms and improve physical function

Answer 12

1. Aerobic

2. Strengthening