FIBROMYALGIA

NAVARRO, Caseyline C.
 What is Fibromyalgia?
• Fibromyalgia is a chronic condition
characterized by widespread pain, stiffness,
and tenderness of the muscles, tendons, and
joints that covers half the body (right or left
half, upper or lower half) and has lasted for
more than 3 months.
 What is Fibromyalgia?
• The precise cause of fibromyalgia is not known
• Fibromyalgia can occur on its own, but it has
also been linked to family history, stressful or
traumatic, psychological distress, trauma,
illness, injury, and/or infection.
 Types of fibromyalgia
• Primary fibromyalgia
– is normally what doctors accept as the most
frequently occurring form of the disease.
– there are 18 designated tender points. Once
doctors rule out other diseases, if they locate at
least 11 of these tender points on the patient,
they confirm the diagnosis of fibromyalgia
 Types of fibromyalgia
• Concomitant fibromyalgia
– occurs with other conditions that don't even seem
related to the fibromyalgia. Scoliosis and
osteoarthritis are two of them.
• Secondary fibromyalgia
– occurs because of another disease or injury.
 Aggravating factors
• Inactivity
• Humidity, Cold, Weather changes
• Stress, Anxiety
• Poor sleep
 Epidemiology
• still remains elusive
– affects 2-7% of the population
– 10x more common in women
– most people are diagnosed during early to middle
adulthood.
– can occur by itself, but people with certain other
diseases, such as RA and other types of arthritis,
may be more likely to have it
 Etiology
• The precise cause of FM is unknown, and likely
multifactorial.
• FM can be triggered by a physicaltrauma
(whiplash, spinal injury, surgery, viral illness)
• Some studies have shown a genetic
component with a strong familial pattern.
• In some patients there is no obvious trigger, or
sudden onset, but a slow gradual onset of
symptoms
Pathomechanism
 FM vs. MPS
Fibromyalgia
• Pain in muscles
• Decreased range of motion
• Postural stresses
• Tender points
• Poor sleep
• No referred pattern of pain
• Fatigue
• Widespread pain syndrome
• Generally chronic
MPS
• Pain in muscles
• Decreased range of motion
• Postural stresses
• Trigger points in muscle
•
• Referred patterns of pain
• Tight band of muscle
• Regional pain syndrome
• Can be resolved with
manual muscle therapies
 What is Tender Point?
• Tender points are specific places on the body (18 specific
points at 9 bilateral locations) that are exceptionally sensitive
to the touch in people with fibromyalgia upon examination
 Clinical Manifestation
• Trouble sleeping • Additional symptoms
• Morning stiffness include 11 of 18 tender
• Headaches points at specific sites
throughout the body.
• Irritable bowel
syndrome • Bilateral, above and
below the waist, along
• Numbness or tingling of the axial skeleton
hands and feet
• Restless legs syndrome
• Temperature sensitivity
• Sensitivity to loud
noises or bright lights
 What happens if
Fibromyalgia is

UNTREATED..?
 Untreated fibromyalgia ultimately
leads to a "tartar of joints" that we
recognize as

osteoarthritis
 Management
• The treatment plan that medical professionals
follow for fibromyalgia should have the goal of
minimizing the symptoms and improving the
overall health of the individual who has
fibromyalgia.
 Management
• Proper posture
• Balance
• Mm tone
• Physical Conditioning
• Low Impact Aerobic Exercise
 Drug fibromyalgia
• S-adenosylmethionine (SAMe): 400 to 1,600
mg/day in divided doses
• St. John's wort: 900 mg/day in divided doses
Melatonin: no agreed recommendations
 Drug
• Three medicines have been approved by the
U.S. Food and Drug Administration (FDA) to
treat fibromyalgia. These are:
- Pregabalin (Lyrica ®)
- Duloxetine (Cymbalta ®)
- Milnacipran (Savella ®)
• Doctors may also suggest non-narcotic pain
relievers, low-dose antidepressants, or other
classes of medications that might help
improve certain symptoms
 Prognosis
• improvement is common, but recovery is rare
• with long-term follow-up studies demonstrating
limited or no improvement
• People with fibromyalgia experience greater
psychological distress and a greater impact on
quality of life
• About half of all patients have difficulty with
routine daily activities, or are unable to perform
them
• An estimated 30 - 40% of patients have had to
quit work or change jobs.
 REFERENCE
• Therapeutic Exercise, Kisner
• Physical Rehabilitation, Braddom
• http://www.ncbi.nlm.nih.gov/pmc/articles/P
MC2821819/
• http://www.medicinenet.com/fibromyalgia/ar
ticle.htm
• http://www.she-health-living.com/Medicine-
for-Fibromyalgia.html