Fibromyalgia and chronic fatigue syndrome Flashcards
What sex does fibromyalgia tend to affect?
F>M 6:1
What are the RFs for fibromyalgia?
- Female
- 30-50yrs
- Low household income
- Divorced
- Low educational status
How does fibromyalgia present?
- CHRONIC PAIN (3m) - widespread, ‘all over’, bilateral,above and below waist + axial skeleton
- FATIGUE
- EXERCISE ↑ PAIN + FATIGUE
- Morning stiffness, paraesthesia, headaches, poor conc, low mood, poor sleep
- Widespread severe tender points
How would you investigate fibromyalgia, what would u find?
ALL NORMAL
Over Ix can consolidate illness behaviour
Exclude other causes e.g. RA, PMR, vasculitis, thyroid, myeloma
What points to a diagnosis of fibromyalgia?
11/18 of the 9 pairs of tender points on the body are tender
What is the conservative management of fibromyalgia?
Psychosocial and MDT approach New sx fully reviewed EXPLAIN situation well Aerobic exercise CBT
What are pharmacological rx for fibromyalgia?
Low dose amitriptyline
Pregabalin
Duloxetine/SSRI
What is chronic fatigue syndrome (CFS) also known as?
Myalgic encephalo-myelitis
What is CFS?
persistent and disabling fatigue lasting >4m affecting mental + physical function which is present >50% of the time
What are the features of CFS?
FATIGUE myalgia polyarthralgia poor memory unrefreshing sleep fatigue after exertion >24hr Persistent sore throat Tender cervical/axillary LNs
What investigations would you do in CFS?
EXCLUDE OTHER PATHOLOGY
FBC, U+E, LFT, glucose, TFT, ESR, CRP, Ca2+, CK, coeliac, ferritin (young and children), urinalysis
What is the management of CFS?
Similar to fibromyalgia
Graded exercise
CBT
NO pharmacological agents have proved effective
Refer to pain management clinic if pain is main sx
What is the main difference between CFS and fibromyalgia?
CFS - main sx is fatigue
Fibromyalgia - main sx is pain
