Fibromyalgia & Chronic Pain

Question 1

What is Fibromyalgia?

Answer 1

Syndrome characterised by widespread pain throughout the body with tender points at specific anatomical sites.

Question 2

Epidemiology of Fibromyalgia.

Answer 2

1. Women 5:1 Men.

2. Age : 30-50.

Question 3

Clinical Features of Fibromyalgia (4).

Answer 3

1. Chronic Pain at Multiple Sites.
2. Lethargy.
3. Cognitive Impairment : FibroFog.
4. Sleep Disturbance, Headaches, Dizziness.

Question 4

Diagnosis of Fibromyalgia.

Answer 4

Clinical - tenderness at 11 of 18 joints in the body lasting at least 3 months, front, back, right and left, above and below diaphragm.

Question 5

Management of Fibromyalgia.

Answer 5

1. Information Giving.
2. Aerobic Exercise.
3. CBT.
4. Neuropathic Pain Relief Medications.

Question 6

What is the difference between Acute and Chronic Pain?

Answer 6

Acute - new onset.

Chronic - 3+ months.

Question 7

What are the 2 types of chronic pain?

Answer 7

1. Chronic Primary Pain - no underlying condition adequately explains the pain.
2. Chronic Secondary Pain - underlying condition explains the pain.

Question 8

What medications should not be started on for Chronic Primary Pain? (5)

Answer 8

All forms of analgesia :

1. Paracetamol.
2. NSAIDs.
3. Opiates.
4. Pregabalin.
5. Gabapentin.

Question 9

What medications should be used to treat Chronic Secondary Pain? (3)

Answer 9

1. Oral Paracetamol and Topical NSAIDs.
2. Oral NSAIDs (with PPI).
3. Opiates e.g. Codeine.