Fibromyalgia

Question 1

What is fibromyalgia

Answer 1

Unexplained condition causing widespread muscle pain and fatigue

Question 2

Who does fibromyalgia commonly affect?

Answer 2

Young and middle-aged women

Question 3

What is thought to be the cause of fibromyalgia?

Answer 3

Disorder of central pain processing or a syndrome of central sensitivity.

Question 4

Associated conditions with fibromyalgia

Answer 4

Seen in 25% of patients with RA and approx. 50% of patients with SLE
Depression
IBS
Migraine

Question 5

Presentation of fibromyalgia

Answer 5

Persistent (more than 3 months) widespread pain (bilateral, affecting above and below the waist, and including the axial spine)
Fatigue
Disrupted/unrefreshing sleep
Cognitive difficulties
Anxiety
Depression
Functional impairment of activities of daily living (ADL)

Question 6

Fibromyalgia investigations

Answer 6

Diagnosis made on clinical basis

Must rule out SLE, hypothyroidism, RA, polymyalgia rheumatica and other inflammatory/autoimmune disorders

Question 7

Management of fibromyalgia

Answer 7

Self-management techniques
Advice regarding graded activity and activity pacing
Atypical analgesia: tricyclics e.g. amitriptyline), gabapentin, pregabalin
Psychological input (CBT)