FIBROMYALGIA

SUMMARY

1. Fibromyalgia (FM) is a hypersensitivity syndrome characterized by hyperalgesia.

2. More women are affected, female:male ratio is 10:1.

3. Patients often complain of diffuse myalgias, all-day stiffness, excessive fatigue, and non-restorative sleep. Can co-exist with depression, psychological issues and other nebulous conditions.

4. Symptoms must be present at a similar level for 2-3 mths, with pain above and below the waist; Ddx to exclude: hypothyroidism, OSA, anaemia.

5. Inx: FBC, ESR, CRP, LFT.

6. Non-pharmacologic therapy with CBT & exercise is the the foundation of FM management. Others: SSRI, Tramadol (note risk of serotonin syndrome), Pregabalin, Gabapentin.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].