Musc Dis- Fibromyalgia

Question 1

what is fibromyalgia (3)

Answer 1

unexplained condition causing widespread muscle pain and fatigue.

it is commonest in young and middle aged women but can affect anyone.

seen in approximately 25% of patients with RA and approximately 50% of patients with SLE.

Question 2

pathogenesis

Answer 2

the pathogenesis of fibromyalgia is not completely understood, research shows biochemical, metabolic, and immunoregulatory abnormalities.

Question 3

signs & symptoms (6)

Answer 3

Persistent (≥ 3 months) widespread pain (pain/tenderness on both sides of the body, above and below the waist, and includes the axial spine

Fatigue; disrupted and unrefreshing sleep

Cognitive difficulties

anxiety and/or depression and functional impairment (ADLs)

irritable bowel syndrome

migraine.

Question 4

Investigations (6)

Answer 4

There are no specific investigations and diagnosis is made on a clinical basis.

rule out other conditions which may present in a similar way such as;
hypothyroidism

(RA)

(SLE)

polymyalgia rheumatica

Question 5

Management (4)

Answer 5

self-management techniques and understand the condition.

Advice regarding graded exercise and activity pacing is useful.

Atypical analgesia including tricyclics (e.g. amitriptyline), gabapentin and pregabalin may be of benefit.

Psychological input with techniques such a cognitive behavioural therapy may help some patients.