Transcript Pain Syndromes: Fibromyalgia Syndrome

Fibromyalgia Syndrome
Fibromyalgia Syndrome: Definition
• Chronic musculoskeletal pain of >3 months’
duration throughout body
• Pain arises outside the joint capsule and
periosteum and is associated with the
demonstration of at least 11 of a possible 18
“tender” point sites
• The “tender” points are elicited by applying 4 kg of
pressure to each of the 18 defined tender point
sites
• Some have viewed fibromyalgia syndrome as a
disorder of “widespread allodynia”
Fibromyalgia Syndrome:
Epidemiology
• 4–7 times more common in adult women than in
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men, with highest prevalence in women age 50–
60 y
Approximately 2% of general population in the
US and Canada have symptoms that could meet
ACR criteria
Long-term follow-up studies have suggested that
fibromyalgia is not a syndrome representing a
transition from 1 disorder to another
Fibromyalgia Syndrome:
Pathophysiology
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Central nervous system abnormalities
Muscle pathology
Psychopathology
Genetic predisposition
Fibromyalgia Syndrome:
Clinical Characteristics
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Pain
Lightheadedness, dizziness, syncope
Fatigue
Chronic insomnia
Cognitive deficits/short-term memory loss
Depression/anxiety
Numbness, dysesthesias in hands and feet
Fibromyalgia Syndrome:
Diagnosis/Treatment
• The diagnosis is made clinically; there are no
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specific blood tests or other tests to “prove” the
presence of fibromyalgia syndrome
Patient education can be invaluable
Physical exercise is vital to successful treatment
Although the use of pharmacologic therapies
could be enhanced by improved knowledge
regarding the pathophysiology of fibromyalgia
syndrome, all medical therapies have been used
with varying degrees of success