Fibromyalgia

Question 1

what is the pathogenesis?

Answer 1

unexplained

Question 2

what is it?

Answer 2

widespread muscle pain and fatigue thought to be a disorder of central pain processing/syndrome of central sensitivity biochemical, metabolic and immunoregulatory abnormalities

Question 3

how does it present?

Answer 3

persistent >3months widespread pain - pain/tenderness on both sides of the body - above and below the waist - includes axial spine fatigue - disrupted and unrefreshing sleepcognitive difficulties multiple other unexplained symptoms anxiety depression functional impairment of activities of daily living (ADLs)

Question 4

how is it investigated?

Answer 4

no specific investigations diagnosis on a clinical basis rule out other conditions - hypothyroidism - RA- SLE- PMR (polymyalgia rheumatica)- other inflammatory/AI

Question 5

how is it managed?

Answer 5

learn self-management techniques understand the condition validate the patients illness graded exercise and activity pacing atypical analgesia - tricyclis (amitriptyline), gabapentin, pregabalin psychological input with CBT may help some patients