Fibromyalgia

Etiology

  • Central pain processing problem

Risk Factors

  • Female > male

Symptoms

  • Chronic pain that's diffuse, multi-site, sometimes migratory
  • Duration > 3 months
  • If there's a precipitant (e.g. accident or injury), may seem relatively mild
  • Pain can wax/wane
  • Often paresthesias/neuropathic quality
  • Can be provoked by light contact (e.g. clothing)
  • Often joint pain, disordered sleep
  • Often profound fatigue
  • May have neuro-psychiatric symptoms including anxiety, depression, difficulty w/memory, sense of fogginess
  • Related sx can include ha, depression, dysmennhorea, fatigue, TMJ, IBS, neck and back pain
  • Can occur concomitant w/RA, OA, other inflammatory d/o
  • Patient self report multi-site pain; can use body chart, Widespread Pain Index (WPI), Symptoms Severity Score (SSS) to assist w/dx

Physical Exam Findings

  • No structural abnormality or inflammation to explain sx
  • Sometimes diffuse tenderness on palpation, even w/light pressure
  • Full ROM of joints, but with pain

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