Fibromyalgia

Laura Dunn

IntroductionDefinition:

A chronic disorder characterized by widespread pain, tenderness, and stiffness of muscles and associated connective tissue structures that is

typically accompanied by fatigue, headache, and sleep disturbances—called also fibromyalgia syndrome, fibromyositis.

Merriam-Webster (2015)

Who does it affect?• Affects 7x more women than men (Causes of Fibromyalgia, 2005)

• Typically develops between 25 and 55• 1 in 25 people affected

Risk factors• Genes (Driver, 2016)

• Comorbidities• Physical trauma (Fibromyalgia causes | arthritis foundation)

Signs and symptoms

(Johnson and Pacific, 2016)

Tender points

18 tender points for the diagnosis of fibromyalgia(Fibromyalgia tender points diagram)

Abnormal pain sensation

• Hyperalgesia- heightened sensitivity to pain• Allodynia- pain caused by stimuli which doesn’t normally cause pain

(Jahan et al., 2012)

Case studyHPC• Fatigue• Pain-burning• stiffness

PMH• Depression• Diabetes• Chronic LBP

NRS 10/10

Aggs• Stress• Over doing activities

Eases• swimming

DHGabapentinCitalopram

TreatmentsPhysiotherapy• Exercise (aerobic/relaxation/stretching/ strengthening)

Acupuncture (Márquez-Zurita et al., 2016)

• Massage (Yuan, Matsutani, and Marques, 2015)

Other treatments• OT- (CBT, pacing, pain management)• Medication- Amitriptyline, pregabalin,gabapentin, tramadol• Psychotherapy

(Fibromyalgia - Physiopedia, universal access to physiotherapy knowledge)

References• Causes of Fibromyalgia (2005) Available at:

http://www.webmd.com/fibromyalgia/guide/fibromyalgia-causes (Accessed: 26 October 2016).

• Choices, N. (2016) Fibromyalgia. Available at: http://www.nhs.uk/Conditions/Fibromyalgia/Pages/Introduction.aspx (Accessed: 26 October 2016).

• Driver, C.B. (2016) Fibromyalgia symptoms, treatment, causes - is fibromyalgia hereditary?Available at: http://www.medicinenet.com/fibromyalgia_facts/page2.htm (Accessed: 26 October 2016).

• Fibromyalgia causes | arthritis foundation (no date) Available at: http://www.arthritis.org/about-arthritis/types/fibromyalgia/causes.php (Accessed: 26 October 2016).

• Fibromyalgia - Physiopedia, universal access to physiotherapy knowledge . Available at: http://www.physio-pedia.com/Fibromyalgia (Accessed: 26 October 2016).

• Fibromyalgia tender points diagram (no date) Available at: https://www.google.co.uk/search?q=fibromyalgia+tender+points+diagram&biw=1280&bih=923&source=lnms&tbm=isch&sa=X&sqi=2&ved=0ahUKEwi2xqWSvPjPAhWRhRoKHWeyA0AQ_AUIBigB&dpr=1&safe=active&ssui=on#imgrc=NdyTGjIF70V6hM%3A (Accessed: 26 October 2016).

References • Jahan, F., Nanji, K., Qidwai, W. and Qasim, R. (2012) ‘Fibromyalgia syndrome: An overview of

Pathophysiology, diagnosis and management’, Oman Medical Journal, 27(3), pp. 192–195. doi: 10.5001/omj.2012.44.

• Johnson, R.K. and Pacific (2016) ‘Yoga as an effective therapy to reduce symptoms in patients with Fibro’ by Rachel K. Johnson. Available at: http://commons.pacificu.edu/pa/558/?utm_source=commons.pacificu.edu%2Fpa%2F558&utm_medium=PDF&utm_campaign=PDFCoverPages (Accessed: 26 October 2016).

• Márquez-Zurita, C., Santos-Rey, K., Navarro-Pablo, R., Modesto, M., Aguilar, I., Vas, J., Aguilar-Velasco, J.F., Romero, M., Párraga, P., Hervás, V., Santamaría, O. and Campos, Á.M. (2016) ‘Acupuncture for fibromyalgia in primary care: A randomised controlled trial’, Acupuncture in Medicine, , pp. 10950–2015. doi: 10.1136/acupmed-2015-010950.

• Merriam-Webster (2015) Definition of FIBROMYALGIA. Available at: http://www.merriam-webster.com/dictionary/fibromyalgia (Accessed: 26 October 2016).

• Yuan, S.L.K., Matsutani, L.A. and Marques, A.P. (2015) ‘Effectiveness of different styles of massage therapy in fibromyalgia: A systematic review and meta-analysis’, Manual Therapy, 20(2), pp. 257–264. doi: 10.1016/j.math.2014.09.003