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Pathology
Fibromyalgia is a syndrome of persistent widespread pain, fatigue, disrupted sleep, and cognitive difficulties typically in young or middle-aged women
Aetiology
Multifactorial and includes both environmental and genetic factors. May be functional disorder
It is a neurosensory disorder of central pain processing or a syndrome of central sensitivity
Signs
Anxiety, depression, tender joints
Symptoms
Chronic widespread pain lasting more than 3 months, with associated fatigue, poor sleep, stiffness, cognitive difficulties, anxiety and/or depression
Physical examination is usually normal except multiple tender points
Criteria for diagnosis:
• Widespread pain in all four quadrants of the body
• Present for at least 3 months
• 11 out of 18 tender points
Investigations
Bloods: Normal
Treatment
Conservative: Education about condition, Graded exercise over several sessions
Relaxation techniques
Medical: Antidepressants, muscle relaxants, gabapentin
Prognosis
Psychosocial risk factors for developing chronic pain and long term disability
Marked functional impairment, severe depression and anxiety
Key Facts
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Key Images
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Key References
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