Fibromyalgia Lecture Powerpoint Flashcards
Fibromyalgia definition
Common cause in women age 20-55 of chronic widespread musculoskeletal pain, accompanied by fatigue, cognitive disturbance, and multiple somatic symptoms, etiology is unknown, pathophysiology is uncertain, despite symptoms of pain affecting muscles, ligaments, and tendons there is no evidence of tissue inflammation
Clinical manifestations of fibromyalgia (6)
- Diffuse bilateral top to bottom widespread musculoskeletal pain** involving both sides of body and areas above and below waist
- poor sleep patterns
- fatigue exacerbated by minor activities
- association with other disorders such as IBS, neuropathy, migraines, chronic bladder irritation
- tenderness at multiple soft tissue anatomic locations
- cognitive and mood disturbances
Central sensitization
Idea that fibromyalgia is a disorder of pain regulation that causes the brain to feel far more pain
Sleep EEG in fibromyalgia
See delta sleep with alpha intrusion similar to what is seen in normal nonREM sleep but with consistent stage 4 sleep deprivation
Lab evals to rule out fibromyalgia (4)
- CBC
- ESR
- thyroid function test
- biochemical screen
2010 AC criteria for diagnosis of fibromyalgia
- rely only upon symptoms, disregard tender point evaluation
- symptoms at least 3 months where no other disorder would explain, wide spread pain presence and fatigue
Differential diagnosis of fibromyalgia (6)
- SLE
- sjogrens
- RA
- hypothyroidism
- polymyalgia reumatica
- myofascial pain syndrome
Poor prognostic indicators of fibromyalgia (3)
- symptoms for long period
- severe symptoms with limitation of activities
- work disability
Management of fibromyalgia (8)
- rule out other disease
- education and support
- exercise (stretching and aerobic activity)
- improve sleep hygiene
- avoid caffeine and tobacco
- Nsaids
- antidepressants
- muscle relaxant
