Fibromyalgia/chronic pain Flashcards
what is the most common cause of chronic widespread pain (CWP)
fibromyalgia
FM can be hard for providers and patients because (2)
patients do not appear ill
labs/imaging or normal
FM is more common in what sex
females
conditions with fibromyalgia diagnosis
WPI >7/19
SS (severity scale) >5
OR
WPI>3
SS>9
for symptoms for at least 3 months!
what are the symptoms of fibromyalgia
generalized pain, fatigue, sleep disturbances, widespread musculoskeletal pain
fatigue/sleep disturbances
congivitive disturbances, headache, parathesias, IBS etc.
1 in 4 patients with FM will also have
50% will have
depression
cephalgias
sleep disorders in FM are selective of _ dysfunction
CNS
abnormal sleep patterns usually precede FM pain ( most people have sleep disturbances)
main finding in the physical exam of FM
tender points (not required for diagnosis anymore)
in order to diagnose FM you must rule out?
other inflammatory conditions
pain processing in FM pts
may have a lower pain threshold
may have a problem with pain processing (up regulation of pain)
temporal summation of pain is greater, pain receptors and pain neuropeptides may be higher)
how can we treat FM
educate the patient and reassure them ( promptly)
manage the stress/modd
give accurate prognosis ( that the pain and fatigue may persist and other symptoms may come and go BUT they can lead a normal life)
encourage exercise
refer to sleep study if sleep is an issue’
OMM (indirect MFR)
vitamin D supplementation
_ is efficacious in FM patients to reduce pain and improve function
exercise
start slow and increase
water aerobics, yoga, tai chi
the EULAR was weak against
NSAIDS
MAOIs
SSRI
EULAR was weak for
amitriptyline, anticonvulsants, cyclobenzaprine , tramadol
acupuncture
EULAR was strong against
growth hormone
sodium oxybate evaluation
