Fibromyalgia Flashcards
FM is a syndrome of:
Persistent, widespread pain, stiffness, fatigue, disrupted and unrefreshing sleep, cognitive difficulties, anxiety and depression
FM typically presents in
young or middle aged women
MC in AA women in US, adolescence
peak prevalence is 60-70
FM patho
disorder of central pain processing or a syndrome of central sensitivity
altered functional connectivity and chemistry in pain processing system of the brain
therefore they experience increased sensation
pain response in fibromyalgia
while usually pain is adaptive – in fibromyalgia the pain response is maladaptive
fibromyalgia etiologies (list)
- genetics
- female sex hormones
- sleep
- physical deconditioning
- stress dysregulation
- psychologic factors
genetics in FM
altered serotonin metabolism
sleep/deconditioning in FM
sleep poorly + more painful days
sedentary persons experience sleep disruption
FM symptoms
- widespread MSK pain
- fatigue
- anxiety and depression
- headache
MSK pain in FM
hurts all over
pain is localized to muscle + joints
100% of patients
fatigue in FM
unrefreshed from sleep
frequently awaken early in AM and difficulty getting back to sleep
original diagnostic evaluation of FM
widespread pain and tenderness at least 3 months both above and below waist bilaterally
mush have 11/18 points to be tender on FM
WPI
ask patient about 19 areas of pain in last week
SS score
fatigue, waking unrested, cognitive symptoms and clinician assigns severity score
low, mod, high to history max 12
diagnostic criteria for FM
- WPI > 7 + SS >5 or WPI 3-6 and SS > 9
- symptoms present for at least 3 months
- not a better disorder
FM tx goals
reducing major symptoms of d/o
chronic widespread pain, fatigue, insomnia, and cognitive dysfunction
