Fibromyalgia (KEY POINTS)

Question 1

What is the pathophys of fibromyalgia?

Answer 1

Disengaged from noxious stimuli or healing

Centralized pain/sensitization d/o

Diffuse hyperalgesia &/or allodynia

Question 2

Why is CNS dysfunction suggested in fibromyalgia?

Answer 2

Due to sleep & mood disturbances noted in the majority of pts

Question 3

Explain the fibromyalgia survey criteria

Answer 3

0-31 pts total

• 0-19 pts for # of body areas w/ pain
• 0-3 pts for presence/severity of fatigue & sleep
• 1 pt each for depression, IB sx, & HAs

*12-13 pts = dx

Question 4

Which drugs provide moderate degrees of benefit for pain & sleep, but only in a minority of pts?

Answer 4

Amitriptyline (TCA)

Cyclobenzaprine (muscle relaxor)

Duloxetine (SNRI)

Gabapentin, pregabalin (anticonvulsants)