Regional MSK and soft tissue disorders Flashcards
RF for fibromyalgia
female
middle age
low household income
divorced
low education status
Associations for fibromyalgia
chronic fatigue syndrome
IBS
chronic headache syndrome
RA, SA or SLE
Features of fibromyalgia
chronic pain: at multiple sites “pain all over”
lethargy
cognitive impairment, “fibro fog”
sleep disturbance
headaches
dizziness
poor conc.
low mood
Investigations for fibromyalgia
all normal
clinical diagnosis
over investigations can consolidate illness behaviour - exclude other causes of pain and/or fatigue
Mx of fibromyalgia
explanation of condition
aerobic exercise: pacing of activity is vital to avoid over-exertion and consequent pain and fatigue
PT
CBT: help develop coping strategies and set achievable goals
meds: pregabalin, duloxetine, amitriptyline
What is chronic fatigue syndrome?
complex and debilitating condition
persistent fatigue, not relieved by rest often accompanied by muscle pain, headaches and cognitive impariment
Features of cauda equina syndrome
3 core sx MUST be present:
- substantial reduction or impairment in ability to engage in pre-illness levels of activities for >6m + fatigue
- post-exertional malaise (PEM): worsening of sx following physical or mental exertion
- unrefreshing sleep despite adequate hours of sleep
1 of 2 must be present:
- cognitive impairment affecting attention, memory, information processing speed or executive function
- orthostatic intolerance - lightheadedness, dizziness or fainting upon standing up
Mx of chronic fatigue syndrome
refer to specialist CSF service if meet diagnostic criteria and sx have persisted for 3m
energy mx: self-management strategy that involved a person managing activities to stay within energy limit
do no advise people with ME/CFS to undertake exercise that is not part of a programme overseen by an ME/CFS specialist team
CBT: supportive not curative
