Fibromyalgia Flashcards
(47 cards)
What is Fibromyalgia?
“Widespread pain occurring for >3 months and pain in at least 11 out of 18 areas”
What’s the cause for Fibro?
Unknown
Can be idiopathic or preceded by traumatic event or viral illness
Thought to be associated with abnormal peripheral nociceptive mechanisms and central pain processing
True/ False
Fibro is the third most commonly diagnosed rheumatic disorder after OA and RA
True
Is it more common in males or females
Females
What’s the onset?
29-37 years old
What age is it usually diagnosed at?
43-53 years old
What’s the prevalence in the population?
2-4% of the American population
What are the Hallmark Symptoms? (5)
Widespread pain Tender points Fatigue Sleep disturbances HAs
Where are tender points mainly located?
Cluster around neck and shoulders, upper chest wall, and lower back
Define Trigger point vs tender point:
Trigger point: “localized spot within a firm area of muscle (taut band) that elicits a characteristic pattern of radiating pain, tingling, or numbness in response to sustained pressure”
Tender point: “can occur in muscle, ligament, tendon, or periosteal tissue, localized rather than referred pain to adjacent areas upon sustained stimulation”
How should we palpate for tender points?
“Palpated bilaterally, at each site using thumb or first 2 fingers to apply steady, uniform pressure firmly enough to blanch the examiner’s nail bed”
Name other conditions that could be present in the pt’s history (10)
Central sensitization
Anxiety, depression, mood disorders, sleep disturbances
Chronic tension and migraine HAs
PTSD and sexual abuse Bowel and bladder irritability/IBS Dysmenorrhea Paresthesia Raynaud’s phenomenon Chest pain Swelling and numbness of extremities
What are 4 important aspects in the exam in order to establish the diagnosis?
- American College of Rheumatology Classification of Fibromyalgia (Tender Point Chart)
- Detailed history
- Thorough exam
- Blood work for differential diagnosis
Why would you use blood work in the differential diagnosis (2)
Pts may have comorbidities that present with similar s/s
Blood work can help rule in/out other diagnoses that may need to be addressed as well
What are the 8 components of the Multifactorial Approach in Fibro management
Patient education Traditional exercise Aquatic therapy Pharmacology Psychosocial factors Modalities Outcome measures Patient resources
What should Pt Ed include? (7)
Information about disease process
Established disease
Coping strategies
Stress management
Proper body mechanics
Energy conservation
Improvement in sleep
Proper nutrition
Alcohol, caffeine, nicotine determine sleep and energy levels
Carbs increase serotonin
Supplements
What are the recommendations for exercise in management of Fibro?
Aerobic exercise
Strengthening exercise
Moderate intensity
Pts with Fibromyalgia are known to be aerobically unfit with poor strength and flexibility
What are the recommended parameters for aerobic exercise?
20-30 minutes 2-3x/week Low impact aerobic exercise: Walking, cycling, swimming 60-70% max HR
How do you determine max HR?
220-age
What are the recommended parameters for strengthening exercise?
30 min
2-3x/week
Self-selected resistance
Increase resistance according to pt tolerance
Starting with less reps (4-5) progressing to 12 may be more beneficial for these pts
Free weights and body weights
What is better strengthening or flexibility training?
Strengthening exercises yielded significant benefits compared to flexibility training
What should we know about stretching and Fibro Patients?
Stretching should be mild, kiss the pain
If too intense, may stretch the nerves resulting in neural tension
Max stretching results in limited ROM versus an increase
Light stretching before and after exercise is more appropriate for these pts
What are the benefits of strengthening and aerobic?
Clinical benefits for strength, pain relief, physical disability, depression, quality of sleep, fatigue, tender point counts, and quality of life
True False
Strengthening is better than aerobic
False
Strengthening and aerobic exercise provide similar benefits
