Fibromyalgia

Question 1

Demographics:

Answer 1

Young to middle aged women,

women 7:1 men

Question 2

Aetiology:

Answer 2

Unknown

Question 3

What can aggravate fibromyalgia?

Answer 3

• Environmental or emotional stress
• poor sleep
• trauma
• exposure to dampness or cold
• physician who implies that the disorder is “all in the head.”

Question 4

Does fibromyalgia cause tissue damage?

Answer 4

No, Allodynia is felt in the areas of pain.

Question 5

Signs and symptoms of FM?

Answer 5

Patient has generalised, chronic, wide spread deep pain

Tender points in back of neck, shoulders lower back, hips knees and shins

Problems with concentration and memory
Irritable bowel (diarrhoea, stomach pain)
Anxiety and/or depression, extreme fatigue

Question 6

When is the pain worst for patients with fibromyalgia?

Answer 6

After rest (eg. first thing in the morning) or after activity

Question 7

What objective tests can be done to diagnose fibromyalgia?

Answer 7

None. Only subjective means such as patient self-report forms and clinical psychometric testing.

Question 8

What is the prognosis for fibromyalgia?

Answer 8

There is no cure, best to manage and improve lifestyle and provide support.

Question 9

Implicated Aetiology:

Answer 9

• Abnormal neuroendocrine function
• Excessive ACTH
• Low insulin
• Decreased BOLD in thalamus, basal ganglia and mid brain

Question 10

When is FM diagnosed?

Answer 10

At least 3 months of wide-spread pain

Pain and tenderness in 11/18 of the tender points.

Question 11

What is the the role of aerobic exercise in rehabilitation of FM?

Answer 11

• Low intensity aerobic exercise and pool exercise can improve function and symptoms

Question 12

Exercise recommendations for FM:

Answer 12

Aerobic exercise 2x a week at moderate intensity
• High-intensity exercise should be undertaken with caution
• Exercise prescriptions should be individualised and should include a
long-term plan to maximise functioning and wellbeing
• Small increments
• Low RPE rating may be necessary at first

Question 13

Acute and Chronic Responses to Exercise:

Answer 13

• Post-exertional pain

* Adherence

Question 14

Beneficial Adaptations to Exercise:

Answer 14

• Improved function and well-being
• Reverses physical inactivity spiral
• Important reduced risk of co-morbidities

Question 15

Contraindications and Adverse effects of exercise in FM

Answer 15

• Perceptual and cognitive