Fibromyalgia

Front 1

fibromyalgia

Back 1

-Syndrome associated with chronic wide-spread pain, fatigue, stiffness, poor sleep & presence of discreet tender points
-F>M
-30-60 yo
-nonarticular musculoskeletal pain

Front 2

criteria

Back 2

-widespread body pain
-3 quadrants or more
-at least 3 months duration
-no other cause for pain

Front 3

pathophys

Back 3

-slide 7-8

Front 4

abnml sensory processing in fibromyalgia

Back 4

-amplification of sensory impulses:
1. muscle tension
2. visceral sensations
3. taste and smell
4. sounds, bright lights
5. minor pains

Front 5

central sensitization

Back 5

1. hyperalgesia: Amplified appreciation of painful stimuli
2. allodynia: Normally non-painful stimuli are experienced as being painful
3. expansion of receptive fields: Spread of painful area beyond the site of the initial insult

Front 6

assoc sx

Back 6

1. dizziness
2. HA
3. multiple sensitivities
4. endocrine imbalance
5. irritable bowel/bladder
6. restless leg
7. depresison, anxiety
8. paresthesia
9. exercise intol
10. autonomic dysfunction
11. severe fatigue
12. cognitive dysfunction
13. insomnia

Front 7

exam

Back 7

-11/18 tender points >3mo
-control points (if + think somaization disorder:
1. mid-forehead
2. thumbnail
3. vola surface of mid-forearm
4. ant mid-thigh

Front 8

mgmt- what are you treating?

Back 8

1. pain
2. fatigue
3. non-restoritive sleep
4. psychological sleep
5. deconditioning
6. assoc syndromes

Front 9

tx

Back 9

1. exercise
2. CPAP
3. tricyclics
4. hypnotics
5. muscle relaxants
6. trigger point injections (lidocaine)
7. analgesics
8. Lyrica
9. Cymbalta
10. Savella